Medication/Prior Authorization Specialist Job at CMU Health, Saginaw, MI

RVFlRWhQdlZxdjN2bnVYSFlPdXVEUkVTbHc9PQ==
  • CMU Health
  • Saginaw, MI

Job Description

Join Our Team as a Medication & Prior Authorization Specialist!

Are you a detail-oriented healthcare professional with a passion for streamlining patient care? Do you thrive in fast-paced environments where accuracy and efficiency are key? If so, we want you to join our dynamic outpatient clinic team as a Medication Prior Authorization Specialist!

 

What You’ll Do:

  • Review and process prior authorization requests for medical procedures, tests, medications, and treatments according to insurance guidelines and clinic protocols.
  • Verify patient insurance coverage and eligibility for requested procedures or treatments.
  • Communicate with insurance companies to obtain necessary authorizations and resolve coverage issues.
  • Maintain accurate records of requests, approvals, denials, and appeals, ensuring clear documentation of communication with insurance companies and healthcare providers.
  • Provide patients with updates and guidance on authorization requirements and financial responsibilities.
  • Collaborate with healthcare providers, nurses, and administrative staff to coordinate patient care and ensure compliance with insurance requirements.
  • Prepare and submit appeals for denied authorizations, advocating for patients’ medical needs.
  • Stay updated on insurance policies, regulations, and industry trends related to prior authorization processes.
  • Identify opportunities for process improvements and efficiency enhancements in prior authorization management.

 

What You Bring:

  • Education : High school diploma required; Associate degree preferred.
  • Experience : Minimum of 2 years in prior authorization management in a healthcare setting, preferably in an outpatient clinic or medical office.
  • Skills : Excellent communication skills (verbal and written), strong organizational and time management skills, ability to work independently and prioritize tasks effectively.
  • Preferred Knowledge : Familiarity with medical billing processes and revenue cycle management is a plus.

 

Why You’ll Love Working Here:

  • Be part of a supportive team that values your skills and dedication.
  • Opportunities for professional growth and development.
  • A welcoming and inclusive work environment.

 

Ready to Make a Difference? Apply Now!

CMU is an AA/EO institution, providing equal opportunity to all persons, including minorities, females, veterans, and individuals with disabilities.

 

Job Tags

Full time,

Similar Jobs

Sargent & Lundy

Electrical Engineer - Entry-Level - Oil & Gas Job at Sargent & Lundy

 ...offer you the opportunity to work in a project team environment with other engineers and designers involved in the design, modification, and analysis of new and existing oil and gas facility electrical systems. This position will also offer the opportunity to support the... 

IRA Financial

Video Production Specialist Job at IRA Financial

 ...Job Description Job Overview The Video Production Specialist is responsible for creating and editing video content to produce high quality...  ...with one day per week on site in our South Beach office for filming and working from home the remaining days. Job Structure... 

Maxion Corp

Data Entry Clerk - Work From Home - Remote Job at Maxion Corp

Join Our Team as a Work-From-Home Data Entry Research Panelist! Are you ready to earn money from the comfort of your own home? This exciting opportunity is perfect for anyone with a variety of skills and backgrounds whether youve been an administrative...

Mass FX Media, LLC

Senior Motion Graphics Designer Job at Mass FX Media, LLC

 ...Media is a dynamic and innovative motion design and post-production studio located in...  ...visually stunning animations and motion graphics for brands, shows and films, specializing...  ...flexible WFH policy that allows you to work remotely as needed, but we do not have a hybrid... 

Veolia

River Skimmer Crew Member Job at Veolia

 ...Purpose: This position is created under the requirements of the River Skimming Program Operations and Maintenance agreement between...  ...agreement requires that Veolia provide crew members to assist the boat captain for the Districts river skimming vessel. This is a...