Insurance and Prior Authorization Specialist

🔥 15 hours ago

🚗 Michigan – Remote

🚗 Michigan – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔒 Insurance

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Munson Healthcare

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1915

🏥 Healthcare

Healthcare

Munson Healthcare is northern Michigan’s largest integrated healthcare system, operating multiple hospitals and care facilities including Munson Medical Center, Cadillac Hospital, Charlevoix Hospital, Grayling Hospital, Kalkaska Memorial Health Center, Manistee Hospital, Otsego Memorial Hospital, and Paul Oliver Memorial Hospital. The system offers a broad range of inpatient and outpatient services — cancer care, cardiology, maternity, neurosciences, orthopedics, primary care, radiology and imaging, stroke care, surgery, home health, hospice, laboratory and pharmacy services, physical therapy, urgent care and virtual/telehealth visits — and supports patients with tools such as a patient portal, an Ask‑a‑Nurse hotline, and price/transparency and financial assistance resources. Munson Healthcare also provides community health programs, clinical education, and employment opportunities across its regional network.

📋 Description

• Navigate insurance requirements • Obtain prior authorizations • Verify medical necessity • Coordinate clinical reviews and appeals • Partner with providers, payers, and clinical and financial teams • Resolve barriers and manage changing priorities • Keep services moving forward • Identify process improvements • Support and educate team members • Ensure work is completed accurately and efficiently with the patient experience in mind

🎯 Requirements

• Michigan residents • 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 • Peer review process • Successful completion of Medical Terminology course • Successful completion of Anatomy course • Knowledge of current third-party payer reimbursement rules • All employees must be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella and Varicella • All employees must receive a flu vaccine during the flu season in the year hired and annually thereafter, or receive an approved medical or religious exemption

🏖️ Benefits

• Tuition reimbursement • In-person and online development • Access to career hub • Full benefits • Paid holidays • Generous PTO • Employee discounts • Free individual retirement counseling • Free wellness platform for you and your family • Personalized support for personal or family challenges