CENTRAL AUTHORIZATION SPECIALIST

<p>**Central Authorization Specialist - Responsibilities**</p><p>**- MI Residents Only -**</p><ul><li>Procure and validate insurance authorizations for ordered procedures and post-operative care in accordance with established policies and procedures</li><li>Provide subject matter expertise in precertification and payor authorization processes to ordering physician offices and authorization procurement staff</li><li>Gather feedback from back-end coding, billing, and denial management resources and distribute findings to ordering physicians to promote continuous improvement</li><li>Apply process improvement methodologies to identify and address performance gaps in authorization procurement workflows, education, and patient satisfaction</li><li>Serve as a centralized resource across all practice sites to ensure standardized and consistent authorization procurement for assigned specialty</li><li>Manage designated caseload and plan effectively to meet authorization procurement demands</li></ul> <p>REQUIRED QUALIFICATIONS:</p><ul><li>High school diploma or equivalent; OR 3-5 years of related experience in a medical clinic, hospital, or corporate setting</li><li>Minimum 3-5 years of experience in a medical clinic setting</li><li>Two years of healthcare insurance verification and/or billing experience</li><li>Two to three years of progressively responsible related work experience</li><li>High level of computer literacy</li><li>Knowledge of clinical terminology and coding</li><li>Understanding of patient treatment plans for authorization purposes</li><li>Ability to interpret RN or Physician notes to facilitate authorization procurement</li><li>Ability to evaluate and communicate additional requirements or roadblocks to RN/Physician staff</li><li>Strong organizational and time management skills with ability to prioritize multiple tasks</li><li>Ability to work independently and exercise sound judgment with physicians, payors, and patients</li><li>Strong oral and written communication skills</li><li>Strong analytical and data management capabilities</li><li>Ability to work effectively with all levels of management</li><li>Strong interpersonal communication and negotiation skills</li></ul><p>PREFERRED:</p><ul><li>Additional coursework in business, computers, or healthcare administration</li><li>Experience in a medical or surgical specialty clinic</li><li>Ability to interpret insurance records and related documentation</li><li>Current working knowledge of hospital operations, utilization management, and case management</li><li>Knowledge of managed care reimbursement processes</li><li>General understanding of revenue cycle with emphasis on billing, coding, charge capture, and reimbursement</li><li>Experience interacting with clinicians and finance personnel</li></ul>