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Munson Healthcare

Insurance & Prior Authorization Specialist

Posted 2 days ago
2-5 years experience
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AI Summary

The specialist will navigate insurance requirements, obtain authorizations, and verify medical necessity to ensure patients access needed care. They will also coordinate clinical reviews and appeals while collaborating with providers and financial teams to resolve barriers.

Company Description

*Michigan residents*

More Than Just Care, It’s Community  

Imagine doing meaningful work in a place where people vacation. That’s life at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties.  

If you want a career in healthcare and a lifestyle most people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be Munson Material. To us, that means teammates who live by our values of excellence, teamness, positivity, creativity, and a commitment to creating exceptional experiences for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country.

Invested in You  

  • Grow: Tuition reimbursement, in-person and online development, and access to our career hub to help you advance. 

  • Thrive: Full benefits, paid holidays, generous PTO, employee discounts, and free individual retirement counseling.  

  • Be Well: Free wellness platform for you and your family, plus personalized support for personal or family challenges. 

  • Be Heard: Share your ideas and help shape the way we work through improvement huddles, employee surveys, and town hall meetings  

Job Description

As an Insurance Prior Authorization Specialist, you will be focused on helping patients access the care they need by navigating insurance requirements, obtaining authorizations, verifying medical necessity, coordinating clinical reviews and appeals. You will partner closely with providers, payers, and clinical and financial teams to resolve barriers, manage changing priorities, and keep services moving forward, while also using their expertise to identify process improvements, support and educate team members, and ensure work is completed accurately, efficiently, and with the patient experience in mind

Qualifications

  • Associate’s degree in Health Services Administration or Business related field preferred.  In lieu of degree, 3 years internal revenue cycle experience will be considered, or one year internal insurance verifier. Minimum productivity requirements, and peer review process are required. 
  • Successful completion of Medical Terminology course, and Anatomy course is required.
  • Knowledge of current third-party payer reimbursement rules required.

Additional Information

Are you Munson Material? Apply today! 

Munson Healthcare requires all employees be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella and Varicella. MHC also requires all employees to receive a flu vaccine during the flu season in the year that they are hired and annually thereafter, or receive an approved medical or religious exemption.

  • Shift: Day Shift
  • Status: Full Time
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