Prior Authorization Specialist - Hospital Revenue Cycle - Full-Time - Sheridan, MI

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    "jobTitle": "Prior Authorization Specialist - Hospital Revenue Cycle - Full-Time - Sheridan, MI",
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    "description": "<h1><strong>Prior Authorization Specialist &ndash; Hospital Revenue Cycle &ndash; Full-Time &ndash; Sheridan, MI</strong></h1>\n\n<h3><em><strong>Full-time Prior Authorization Specialist role near Grand Rapids, MI. Hospital experience required. Support surgery, imaging, and admissions in a fast-paced healthcare environment.</strong></em></h3>\n\n<hr />\n<p><strong>Location:</strong> Sheridan, MI (easy commute from Grand Rapids Metro and Lansing)<br />\n<strong>Organization:</strong> Sheridan Community Hospital<br />\n<strong>Department:</strong> Accounting / Revenue Cycle<br />\n<strong>Schedule:</strong> Full-Time | Day Shift<br />\n<strong>Employment Type:</strong> Full-Time</p>\n\n<h2>&nbsp;</h2>\n\n<hr />\n<h2><strong>Keep Patient Care Moving&mdash;From Authorization to Treatment</strong></h2>\n\n<p>Sheridan Community Hospital is seeking a <strong>Prior Authorization Specialist with hospital facility experience</strong> to support our revenue cycle team.</p>\n\n<p>In this role, you will play a critical part in ensuring patients receive <strong>timely access to care</strong> by securing authorizations for procedures, admissions, and specialty services.</p>\n\n<p>This is a high-impact position where your work directly affects <strong>patient outcomes, provider workflow, and hospital revenue integrity</strong>.</p>\n\n<hr />\n<h2><strong>A Location That Works for You</strong></h2>\n\n<p>Sheridan offers a better balance compared to larger health systems:</p>\n\n<ul>\n\t<li>Approximately <strong>45 minutes from Grand Rapids Metro</strong></li>\n\t<li>Approximately <strong>60 minutes from Lansing, MI</strong></li>\n\t<li>Easy commute with less congestion</li>\n\t<li>Close-knit, team-oriented hospital environment</li>\n</ul>\n\n<p>Many team members choose Sheridan for a <strong>more manageable pace and stronger collaboration</strong> while living in nearby cities.</p>\n\n<hr />\n<h2><strong>Why This Role Stands Out</strong></h2>\n\n<ul>\n\t<li>Work across <strong>multiple service lines</strong>:\n\n\t<ul>\n\t\t<li>Surgery</li>\n\t\t<li>Inpatient / observation stays</li>\n\t\t<li>Imaging (including cardiac)</li>\n\t\t<li>Physical therapy</li>\n\t\t<li>Infusions</li>\n\t</ul>\n\t</li>\n\t<li>Direct collaboration with providers, billing, and clinical teams</li>\n\t<li>Opportunity to <strong>own and improve authorization workflows</strong></li>\n\t<li>High visibility role impacting <strong>patient access and revenue cycle performance</strong></li>\n</ul>\n\n<hr />\n<h2><strong>Prior Authorization Specialist Responsibilities</strong></h2>\n\n<ul>\n\t<li>Manage and track incoming authorization requests via EHR, email, phone, and fax</li>\n\t<li>Submit prior authorizations and supporting clinical documentation to insurance carriers</li>\n\t<li>Coordinate with physicians, specialists, and internal departments</li>\n\t<li>Review medical necessity and ensure complete, accurate documentation</li>\n\t<li>Prioritize requests based on patient urgency and service timelines</li>\n\t<li>Follow up with payers to ensure timely approvals and prevent delays in care</li>\n\t<li>Document all communication and status updates in the EHR</li>\n\t<li>Assist with denial review and collaborate with coding/billing teams on appeals</li>\n\t<li>Support referral authorization processes as needed</li>\n\t<li>Maintain compliance with HIPAA and organizational policies</li>\n\t<li>Participate in quality improvement initiatives</li>\n</ul>\n\n<hr />\n<h2><strong>What We&rsquo;re Looking For</strong></h2>\n\n<ul>\n\t<li><strong>Hospital facility experience REQUIRED</strong> (not clinic-only)</li>\n\t<li>High school diploma or equivalent required</li>\n\t<li>Strong knowledge of:\n\t<ul>\n\t\t<li>Insurance authorization processes</li>\n\t\t<li>Medical terminology</li>\n\t\t<li>Healthcare workflows</li>\n\t</ul>\n\t</li>\n\t<li>Experience in <strong>orthopedic and/or neurological authorizations preferred</strong></li>\n\t<li>Proficiency in EHR systems and computer applications</li>\n\t<li>Strong attention to detail and organizational skills</li>\n\t<li>Ability to manage urgent requests and prioritize effectively</li>\n\t<li>Excellent communication and teamwork skills</li>\n</ul>\n\n<hr />\n<h2><strong>What Makes This Role Unique</strong></h2>\n\n<ul>\n\t<li>Work in a <strong>critical access hospital with varied, complex cases</strong></li>\n\t<li>Be part of a <strong>team that directly supports patient access to care</strong></li>\n\t<li>Opportunity to collaborate across multiple departments</li>\n\t<li>Make a measurable impact on <strong>denials reduction and patient flow</strong></li>\n</ul>\n\n<hr />\n<h2><strong>Why You&rsquo;ll Love Working at SCH</strong></h2>\n\n<ul>\n\t<li>Supportive, team-first environment</li>\n\t<li>Strong leadership and cross-department collaboration</li>\n\t<li>Meaningful role tied directly to patient experience</li>\n\t<li>Opportunity for growth within revenue cycle operations</li>\n</ul>\n\n<hr />\n<h2><strong>Benefits You Can Count On</strong></h2>\n\n<ul>\n\t<li>Paid Time Off (PTO)</li>\n\t<li>Paid Holidays</li>\n\t<li>Medical Insurance (multiple plan options)</li>\n\t<li>Dental Insurance</li>\n\t<li>Vision Insurance</li>\n\t<li>Employer-paid Life Insurance</li>\n\t<li>401(k) with employer match</li>\n\t<li>Tuition/Continuing Education Reimbursement</li>\n\t<li>Employee Health Hospital Discount</li>\n</ul>\n\n<hr />\n<h2><strong>What to Expect</strong></h2>\n\n<p>This full-time, day shift role requires strong attention to detail and the ability to manage multiple authorization requests simultaneously. You will work closely with providers, payers, and internal teams to ensure care is delivered without delays.</p>\n\n<hr />\n<h2><strong>Apply Today</strong></h2>\n\n<p>Join a team that values accuracy, collaboration, and community-centered care. Apply today to support patient access and revenue cycle success at Sheridan Community Hospital.</p>\n",
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