PATIENT AUTHORIZATION AND DENIALS SPECIALIST

Employment Type: Full time Shift: Day Shift Description: Position is on site, local residency required Position Purpose This position is responsible for reviewing financial/insurance information obtained to meet State, Federal and Third-Party billing requirements to ensure reimbursement for services. What you will do Responsible for authorization and denials within Case Management ensuring appropriate authorization for inpatient hospital admissions Assists in the identification, reporting and resolution of any issues stemming from or with authorization and denial processes Supports the needs of the Case Management Utilization Coordinator team using data, system reports, and analytics Develops and Implements strategies to optimize all aspects of authorization and denials supporting hospital revenue integrity team through a comprehensive approach Minimum Qualifications Associate degree and 1–2 years of healthcare experience required, or, in lieu of an Associate degree, a high school diploma/GED and 5 or more years of healthcare experience will be considered Medical billing or insurance authorization experience preferred Excellent customer service skills and the ability to communicate professionally required Position Highlights and Benefits Full time 40-hour week - includes every other weekend and rotating Holidays. Pay Differentials will apply! Position is on site, local residency required Great benefits and Health Insurance Coverage - Day 1 Ministry/Facility Information Saint Francis Hospital is committed to exceeding the expectations of our patients and families by providing world-class service in a progressive, people-centered, compassionate health care environment. We are licensed for 617 beds and 65 bassinets, are a major teaching hospital and the largest Catholic hospital in New England. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.