Prior Authorization Rep

2 weeks ago

Grand Rapids, Michigan, United States Corewell Health Full time
Job Summary


Provides clerical support to assist in the delivery of quality healthcare services via a Financial Clearance model by way of obtaining accurate and timely authorizations.

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 90% or higher audit score consistently and be receptive to constructive feedback.

Proficient in one primary service area with a firm understanding of the industry standard authorization requirements.

Able to obtain 15 authorizations daily (consideration for type of service line)

How Corewell Health cares for you

Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here ) .

On-demand pay program powered by Payactiv

Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more

Optional identity theft protection, home and auto insurance, pet insurance

Traditional and Roth retirement options with service contribution and match savings

Qualifications

Required

High School Diploma or equivalent

1 year of relevant experience in related field

Preferred

Prior Authorization experience

Epic experience

Payor portal experience

Basic understanding of medical terminology

About Corewell Health


As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities.

We are committed to cultivating and investing in YOU.

Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope.

Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

Primary Location

SITE - Kentwood Medical Office Building Breton Rd - Kentwood

Department Name

Pre-Authorizations

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

8 a.m. to 4:30 p.m.

Days Worked

Monday to Friday

Weekend Frequency

N/A

CURRENT 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


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.

  • Patient Access Rep Associate Women's Health Scheduling Virtual

    2 weeks ago

    Grand Rapids, Michigan, United States Corewell Health Full time

    Job SummaryAssist and educate patients, providers, medical office staff, and/or Health system staff with accessing services, facilitating and resolving problems, understanding navigation questions. Consistently create an exceptional experience with each contact, via inbound and outbound calls, online chat, email, etc. Adheres to established procedure and...

  • Aerospace Electronics Engineering Manager

    2 weeks ago

    Grand Rapids, Michigan, United States GE Aviation Full time

    Job Description SummaryJoin a high performing team which develops next-generation aerospace computing products for growing military and civil markets. GE Aerospace is looking for an Aerospace Electronics Engineering Manager who will develop products, develop talent, and foster excellence in electronic design. This role requires people leadership and...

  • Aerospace Electronics Engineering Manager

    2 weeks ago

    Grand Rapids, Michigan, United States GE Aviation Full time

    Job Description SummaryJoin a high performing team which develops next-generation aerospace computing products for growing military and civil markets. GE Aerospace is looking for an Aerospace Electronics Engineering Manager who will develop products, develop talent, and foster excellence in electronic design. This role requires people leadership and...

  • Sourcing Specialist

    1 month ago

    Grand Rapids, Michigan, United States GE Aerospace Full time

    Job Description SummaryThe Sourcing Specialist manages the buying process for various commodities as assigned, which might include hardware, chemicals, consumables, non-metallics, etc. The person in this role will apply sourcing policy and interface between suppliers and entities with respect to specifications and budgets. This role requires an in-depth...

  • Aerospace Electronics Engineering Manager

    2 weeks ago

    Grand Rapids, Michigan, United States GE Aerospace Full time

    Job Description SummaryJoin a high performing team which develops next-generation aerospace computing products for growing military and civil markets.GE Aerospace is looking for an Aerospace Electronics Engineering Manager who will develop products, develop talent, and foster excellence in electronic design.This role requires people leadership and experience...

  • Aerospace Electronics Engineering Manager

    1 month ago

    Grand Rapids, Michigan, United States GE Aerospace Full time

    Job Description SummaryJoin a high performing team which develops next-generation aerospace computing products for growing military and civil markets.GE Aerospace is looking for an Aerospace Electronics Engineering Manager who will develop products, develop talent, and foster excellence in electronic design.This role requires people leadership and experience...

  • Customer Care Coordinator

    2 weeks ago

    Grand Rapids, Michigan, United States Hope Network Full time

    The Customer Care Coordinator Role at Hope NetworkKey responsibilities: Facilitating essential customer service delivery to drivers, passengers, caregivers, funders, and the general public. Resolving concerns and issues promptly through communication and problem-solving. Handling telephone, radio communication, and scheduling via computer software to meet...

  • QA Supervisor Aseptic Operations

    2 weeks ago

    Grand Rapids, Michigan, United States Grand River Aseptic Manufacturing Full time

    Quality, Service, Collaboration, Courage. Do you exhibit these values and wish to be around others that do too? Are you interested in making a difference in your community and the world? Are you looking for a place where you can grow and learn in a diverse, community-minded culture? If these statements resonate with you, Grand River Aseptic Manufacturing...

  • Medical Assistant Urologic Consultants

    2 weeks ago

    Grand Rapids, Michigan, United States Michigan Institute of Urology Full time

    Position: Medical Assistant - UrologyLocation: Grand RapidsFull Time: 40-hours/weekDays: Monday-FridayTime: 8am-5pmAbout Us :Urologic Consultants is a private urology practice in partnership with Michigan Institute of Urology and an affiliate of Solaris Health LLC. We have ten providers that specialize in urological care for male, female and pediatric...

  • Lead Supplier Quality Engineer

    1 month ago

    Grand Rapids, Michigan, United States GE Aerospace Full time

    Job Description SummaryThe Lead Supplier Quality Engineer – Sourcing drives quality for assigned suppliers, including quality plan implementation, and selecting suppliers through the qualification processes. This person will own supplier results and audits, and drive improvements utilizing supplier scorecards to ensure compliance. This role requires an...

  • QA Supervisor

    2 weeks ago

    Grand Rapids, Michigan, United States Grand River Aseptic Manufacturing Full time

    Quality, Service, Collaboration, Courage. Do you exhibit these values and wish to be around others that do too? Are you interested in making a difference in your community and the world? Are you looking for a place where you can grow and learn in a diverse, community-minded culture? If these statements resonate with you, Grand River Aseptic Manufacturing...

  • Accounts Receivable Specialist

    2 weeks ago

    Grand Rapids, Michigan, United States Sahr Building Supply Full time

    Accounts Receivable SpecialistSahr has an immediate opening for an Accounts Receivable Specialist. Sahr, with locations in Grand Rapids, Kalamazoo, and Lansing, is a leading supplier of windows, doors, and hardware for both commercial and residential construction projects in Michigan and surrounding states in the Midwest. This position will require...

  • MA or LPN

    2 weeks ago

    Grand Rapids, Michigan, United States Metro Health Full time

    Metro Health now the University of Michigan Health-West is looking for MA - Medical Assistiant or LPN - Licensed Practical Nurse. (SIGN-ON BONUS ELIGIBLE)Enterprises Neuro * Days - 40hs/wkSW Wyoming * Days - 40 hrs/wkMedical Assistant - SW Wyoming * Days - 40 hrs/wkMedical Assistant - Beltline * Days - 40 hrs/wkGeneral Summary:Under the direction of the...

  • Patient Services Representative Breast Clinic

    2 weeks ago

    Grand Rapids, Michigan, United States Spectrum Health Full time

    This is a benefit-eligible position. The starting rate for this position is $ per hour and varies based on experience. Job SummaryProvides clerical support in complex matters to assist in the delivery of quality health care services.Essential Functions Responsible for complex patient/customer problem solving, including high level discernment when...

  • Customer Service Representative

    2 weeks ago

    Grand Rapids, Michigan, United States nextSource Full time

    We are looking for Customer Service Representatives to work in the following locations: Festus, MO; Kent WA; or Memphis, TN As a healthcare customer service representative, you will be responsible for successfully managing large amounts of orders through both inbound and outbound calls and in-person in a center location. This will include following...

  • Receptionist

    2 weeks ago

    Grand Rapids, Michigan, United States Glass Doctor of Western Washington Full time

    Glass Doctor has been serving Western Washington's glass repair needs since 1962 and is currently seeking an enthusiastic Office Receptionist to create positive impressions and assist our valued customers.Responsibilities as an Office Receptionist:Handle a high volume of incoming calls by greeting, welcoming, and directing them appropriately.Ask clarifying...

  • Community/Property Coordinator

    2 weeks ago

    Grand Rapids, Michigan, United States Brio Living Services Full time

    Community CoordinatorPosition Classification: Full-time Schedule: 32 hours per week, flexible schedule Location: Hybrid - onsite 3 days a week Req #: 8288 Why Brio Living Services | Affordable Housing? Make an impact in the lives of older adults, ensuring a gracious, worry-free retirement is available for everyone, regardless of income. Medical & Dental...

  • Community/Property Coordinator

    2 weeks ago

    Grand Rapids, Michigan, United States Brio Living Services Full time

    Job Description Job Description Community Coordinator Position Classification : Full-timeSchedule: 32 hours per week , flexible scheduleLocation:Hybrid - onsite 3 days a weekReq #: 8288Why Brio Living Services | Affordable Housing?Make an impact in the lives of older adults, ensuring a gracious, worry-free retirement is available for everyone, regardless of...

  • Vaccines Account Executive; Grand Rapids, Kalamazoo, MI and South Bend, IN

    1 month ago

    Grand Rapids, Michigan, United States GSK Full time

    For more than 140 years, GSK has pioneered novel research methods and technologies to help protect people from infectious diseases. Our vaccines portfolio of more than 20 marketed vaccines is the broadest in the industry, helping to protect people throughout their lives. We believe prevention, at scale and for impact, is the best health investment for...

  • Hilo Driver

    2 weeks ago

    Grand Rapids, Michigan, United States Pridgeon & Clay Full time

    3rd Shift (10:30pm-7:00am) Overtime available~ Shift differential ($1.00/hr) Mission: The Hilo Driver maintains the flow of unprocessed product to the work area and remove the processed components and scrap from the work area in an exemplary manner according to the company quality policies. Qualified candidates will possess the following Minimum...