Job SummaryProvides clerical support to assist in the delivery of quality healthcare services via a Financial Clearance model by way of obtaining accurate and timely authorizations. Staff will be trained in various clinical service lines with the ability to support multiple areas within the Central Authorization team. Crucial to obtaining an authorization is the ability to read and understand basic insurance information as well as perform a complete and accurate registration. Training will consist of six weeks of in-person instruction and will shift to remote training after that time pursuant on satisfactory progress including authorizations obtained daily and a passing audit score. Essential Functions
Demonstrates the ability to utilize all payer websites and maintains up to date credentials to assist verifying patient’s coordination of benefits and authorization requirements.
Able to perform chart abstraction to pull clinical data from a patient’s chart for review by a payer’s clinical team.
Adheres to all department procedures, guidelines, and standard work with the ability to utilize resources appropriately.
Complete authorization requests in a timely and efficient manor without compromising quality to ensure patients receive their care as scheduled.
Communicates barriers effectively to avoid patient delays in care demonstrating critical thinking skills to anticipate and resolve barriers to success.
Maintains a 95% or higher audit score consistently and be open to constructive feedback
Proficient in two clinical service areas navigating the nuances of those area’s authorization requirements.
Able to obtain 20 authorizations daily (consideration for type of service line).
Qualifications
Required High School Diploma or equivalent Basic understanding of medical terminology preferred
1 year of relevant experience In related field. Required
1 year of relevant experience Prior Authorizations Experience Required
1 year of relevant experience Revenue Cycle Preferred
Epic Experience Preferred
Payor Portal Experience Preferred
Physical Demands
Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs
Waist to Waist > 5 lbs: Seldom up to 10 lbs
Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs
Waist to Overhead > 5 lbs: Seldom up to 10 lbs
Bilateral Carry > 5 lbs: Seldom up to 10 lbs
Unilateral Carry > 5 lbs: Seldom up to 10 lbs
Pushing Force > 5 lbs: Seldom up to 20 lbs
Pulling Force > 5 lbs: Seldom up to 15 lbs
Sitting: Frequently
Standing: Occasionally
Walking: Occasionally
Forward Bend - Standing: Seldom
Forward Bend - Sitting: Occasionally
Trunk Rotation - Standing: Seldom
Trunk Rotation - Sitting: Occasionally
Squat: Seldom
Stair Climbing: Seldom
Reach - Above Shoulder: Seldom
Reach - at Shoulder or Below: Seldom
Handling: Occasionally
Forceful Grip > 5 lbs: Seldom
Forceful Pinch > 2 lbs: Seldom
Finger/Hand Dexterity: Frequently
Visual Acuity ¹ [None = No; Seldom = Yes]: Seldom
Primary LocationSITE - Kentwood Medical Office Building - 4600 Breton Rd - KentwoodDepartment NamePre-AuthorizationsEmployment TypeFull timeShiftDay (United States of America)Weekly Scheduled Hours40Hours of Work8:30 a.m. to 5 p.m.Days WorkedMonday to FridayWeekend FrequencyN/ACURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.You may request assistance in completing the application process by calling 616.486.7447.People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.