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Prior Authorization Specialist- Full Time- M-F- 9am-5pm

391B6A97D5A2B77135D1F5D3AF2FDD8C · Sheridan Community Hospital - Sheridan, MI 48884; 301 N Main Street, Sheridan, MI, 48884, USA · Deleted · Paycom ATS

Job facts

FieldValue
Company391B6A97D5A2B77135D1F5D3AF2FDD8C
TitlePrior Authorization Specialist- Full Time- M-F- 9am-5pm
Normalized title-
Department / team-
LocationSheridan, MI, United States
Work model-
Employment type-
Salary-
Statusdeleted
ATS providerPaycom ATS
Posted / first seen2026-04-07 / 2026-05-31
Changed / last seen2026-06-18 / 2026-06-16

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Linked records

Company391B6A97D5A2B77135D1F5D3AF2FDD8C
Sourcedd354f65-d3a5-45c8-b84c-70d06959d798
ATS providerPaycom ATS

Description

Description Position: Prior Authorization Specialist Reports To: Revenue Cycle Manager Schedule : Full time Position Location/Department: Accounting Job Summary: The prior authorization Specialist will obtain prior authorizations for surgery, swing bed, inpatient/observation stays, emergency services, diagnostic imaging, cardiac imaging, physical therapy, and IV infusions, and referral authorizations for some specialist appointments. This position will secure the prior authorization and notify the rendering party in the timeliest manner possible so our patient receives the services needed without delay. Essential Duties and Responsibilities: Receive requests for prior authorizations through the email, electronic health record (EHR) and /or via phone or fax and ensure that they are properly and closely monitored. Process referrals and submit medical records to insurance carriers to expedite prior authorization processes. Manage correspondence with insurance companies, physicians, specialist and patients as needed, including documenting in the EHR as appropriate. Assist with medical necessity review of documentation to expedite approvals and ensure that appropriate follow-up is performed. Review accuracy and completeness of information requested and ensure that all supporting documents are present. Assist coders/billing staff in the review of denials related to authorizations, and follow up with provider to obtain information for coders/billers to submit an appeal of the denial. Prioritize the incoming authorizations by level of urgency to the patient. Secure patient information in accordance with policy’s/procedures. Participate in quality improvement projects. Attend training and meetings as required Maintains awareness of current quality and safety measures on the unit and follows guidelines or reporting measures to ensure safety of patients, visitors, and staff. Knowledge and skills in quality improvement and research methodologies. Other duties as assigned. Qualifications Education, Experience and Other Requirements: High School diploma or equivalent Previous experience in a hospital and specialty clinic setting preferred Previous experience in orthopedic and neurological authorizations preferred Knowledge of insurance processes and medical terminology required Social and cultural sensitivity appropriate to ethnically and economically diverse patient-and employee-base Communicates through appropriate channels. Use proper chain of command for patient complaints Ability to handle emergency situations calmly and effectively Must be computer literate and able to navigate through the Electronic Health Record Must be able to maintain good inter-personal relationship with co-workers and other members of the health care team and the organization Provide customer service in accordance with the organization’s mission Be courteous and respectful when interacting with patients and family members Maintain patient confidentiality in accordance with organization policies, procedures, and HIPAA requirements

Full job record

Job IDec3768d0e9eee68e7792fb47bd3178dbf7a90359
Org ID218cc319-f37f-4a81-b5e4-b9898dd629e9
Source IDdd354f65-d3a5-45c8-b84c-70d06959d798
Board IDdd354f65-d3a5-45c8-b84c-70d06959d798
Providerpaycom
Provider Job Key801111
TitlePrior Authorization Specialist- Full Time- M-F- 9am-5pm
Normalized Title—
Statusdeleted
Activeno
Location TextSheridan Community Hospital - Sheridan, MI 48884; 301 N Main Street, Sheridan, MI, 48884, USA
Department—
Team—
Employment Type—
Workplace Type—
Remote Policy—
CountryUnited States
RegionMI
CitySheridan
Salary RawDescription Position: Prior Authorization Specialist Reports To: Revenue Cycle Manager Schedule : Full time Position Location/Department: Accounting Job Summary: The prior authorization Specialist will obtain prior authorizations for surgery, swing bed, inpatient/observation stays, emergency services, diagnostic imaging, cardiac imaging, physical therapy, and IV infusions, and referral authorizations for some specialist appointments. This position will secure the prior authorization and notify the rendering party in the timeliest manner possible so our patient receives the services needed without delay. Essential Duties and Responsibilities: Receive requests for prior authorizations through the email, electronic health record (EHR) and /or via phone or fax and ensure that they are properly and closely monitored. Process referrals and submit medical records to insurance carriers to expedite prior authorization processes. Manage correspondence with insurance companies, physicians, specialist and patients as needed, including documenting in the EHR as appropriate. Assist with medical necessity review of documentation to expedite approvals and ensure that appropriate follow-up is performed. Review accuracy and completeness of information requested and ensure that all supporting documents are present. Assist coders/billing staff in the review of denials related to authorizations, and follow up with provider to obtain information for coders/billers to submit an appeal of the denial. Prioritize the incoming authorizations by level of urgency to the patient. Secure patient information in accordance with policy’s/procedures. Participate in quality improvement projects. Attend training and meetings as required Maintains awareness of current quality and safety measures on the unit and follows guidelines or reporting measures to ensure safety of patients, visitors, and staff. Knowledge and skills in quality improvement and research methodologies. Other duties as assigned. Qualifications Education, Experience and Other Requirements: High School diploma or equivalent Previous experience in a hospital and specialty clinic setting preferred Previous experience in orthopedic and neurological authorizations preferred Knowledge of insurance processes and medical terminology required Social and cultural sensitivity appropriate to ethnically and economically diverse patient-and employee-base Communicates through appropriate channels. Use proper chain of command for patient complaints Ability to handle emergency situations calmly and effectively Must be computer literate and able to navigate through the Electronic Health Record Must be able to maintain good inter-personal relationship with co-workers and other members of the health care team and the organization Provide customer service in accordance with the organization’s mission Be courteous and respectful when interacting with patients and family members Maintain patient confidentiality in accordance with organization policies, procedures, and HIPAA requirements
Salary Min—
Salary Max—
Salary Currency—
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Source URLhttps://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=801111&clientkey=391B6A97D5A2B77135D1F5D3AF2FDD8C
Apply URLhttps://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=801111&clientkey=391B6A97D5A2B77135D1F5D3AF2FDD8C
First Seen At2026-05-31 19:07:44Z
Last Seen At2026-06-16 10:12:13Z
Last Checked At2026-06-18 09:19:32Z
Last Changed At2026-06-18 09:19:32Z
Inactive At2026-06-18 09:19:32Z
Source Posted At2026-04-07 00:00:00Z
Source Updated At—
Raw Payload Uris3://job-postings-prod-raw-590183727216/raw/provider=paycom/board=391B6A97D5A2B77135D1F5D3AF2FDD8C/date=2026-06-16/2026-06-16T10-12-11-173Z-eb53a434e70ae8ca6dd8bb3f54118b989fbec074aed384f652465e6cf219d770.json
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Parsed Structured
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    "description": "<p style=\"margin-bottom:11px\"><span style=\"font-size:11pt\"><span style=\"line-height:107%\"><span style=\"font-family:Calibri,sans-serif\"><b><span style=\"font-size:12.0pt\"><span style=\"line-height:107%\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Position:</span></span></span></b><span style=\"font-size:12.0pt\"><span style=\"line-height:107%\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\"> Prior Authorization Specialist</span></span></span></span></span></span></p>\r\n\r\n<p style=\"margin-bottom:11px\"><span style=\"font-size:11pt\"><span style=\"line-height:107%\"><span style=\"font-family:Calibri,sans-serif\"><b><span style=\"font-size:12.0pt\"><span style=\"line-height:107%\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Reports To: Revenue Cycle Manager</span></span></span></b></span></span></span></p>\r\n\r\n<p style=\"margin-bottom:11px\"><span style=\"font-size:11pt\"><span style=\"line-height:107%\"><span style=\"font-family:Calibri,sans-serif\"><b><span style=\"font-size:12.0pt\"><span style=\"line-height:107%\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\"><span style=\"color:#222222\">Schedule</span></span></span></span></b><span style=\"font-size:12.0pt\"><span style=\"line-height:107%\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\"><span style=\"color:#222222\">: Full time</span></span></span></span></span></span></span></p>\r\n\r\n<p style=\"margin-bottom:11px\"><span style=\"font-size:11pt\"><span style=\"line-height:107%\"><span style=\"font-family:Calibri,sans-serif\"><b><span style=\"font-size:12.0pt\"><span style=\"line-height:107%\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\"><span style=\"color:#222222\">Position Location/Department: Accounting</span></span></span></span></b></span></span></span></p>\r\n\r\n<p style=\"margin-bottom:11px\"><span style=\"font-size:11pt\"><span style=\"line-height:107%\"><span style=\"font-family:Calibri,sans-serif\"><b><span style=\"font-size:12.0pt\"><span style=\"line-height:107%\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Job Summary:&nbsp; </span></span></span></b><span style=\"font-size:12.0pt\"><span style=\"line-height:107%\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\"><span style=\"color:#222222\">The prior authorization Specialist will obtain prior authorizations for surgery, swing bed, inpatient/observation stays, emergency services, diagnostic imaging, cardiac imaging, physical therapy, and IV infusions, and referral authorizations for some specialist appointments. 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Attend training and meetings as required</span></span></span></span></span></span></span></li>\r\n\t<li style=\"margin-left:8px\"><span style=\"font-size:11pt\"><span style=\"tab-stops:list .5in\"><span style=\"line-height:107%\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"line-height:107%\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Maintains awareness of current quality and safety measures on the unit and follows guidelines or reporting measures to ensure safety of patients, visitors, and staff.</span></span></span></span></span></span></span></li>\r\n\t<li style=\"margin-bottom:11px; margin-left:8px\"><span style=\"font-size:11pt\"><span style=\"tab-stops:list .5in\"><span style=\"line-height:107%\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"line-height:107%\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Knowledge and skills in quality improvement and research methodologies.</span></span></span></span></span></span></span></li>\r\n\t<li style=\"margin-bottom:11px\"><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Other duties as assigned.</span></span></span></span></span></span></li>\r\n</ul>\r\n\r\n<p style=\"margin-left:48px; margin-bottom:11px\">&nbsp;</p>\r\n",
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Attend training and meetings as required\\r\\n\\tMaintains awareness of current quality and safety measures on the unit and follows guidelines or reporting measures to ensure safety of patients, visitors, and staff.\\r\\n\\tKnowledge and skills in quality improvement and research methodologies.\\r\\n\\tOther duties as assigned.\\r\\n\\r\\n\\r\\n&nbsp;\\r\\n\",\"employmentType\":\"OTHER\",\"hiringOrganization\":{\"@type\":\"Organization\",\"name\":\"SHERIDAN COMMUNITY HOSPITAL\",\"logo\":\"https://www.paycomonline.net/v4/ats/web.php/application/style/logo?clientkey=391B6A97D5A2B77135D1F5D3AF2FDD8C\"},\"jobLocation\":{\"@type\":\"Place\",\"address\":{\"streetAddress\":\"301 N Main Street\",\"addressLocality\":\"Sheridan\",\"addressRegion\":\"MI\",\"postalCode\":48884,\"addressCountry\":\"USA\"}},\"qualifications\":\"Education, Experience and Other Requirements:\\r\\n\\r\\n\\r\\n\\tHigh School diploma or equivalent\\r\\n\\tPrevious experience in a hospital and specialty clinic setting preferred\\r\\n\\tPrevious experience in orthopedic and neurological authorizations preferred\\r\\n\\tKnowledge of insurance processes and medical terminology required\\r\\n\\tSocial and cultural sensitivity appropriate to ethnically and economically diverse patient-and employee-base\\r\\n\\tCommunicates through appropriate channels. Use proper chain of command for patient complaints\\r\\n\\tAbility to handle emergency situations calmly and effectively\\r\\n\\tMust be computer literate and able to navigate through the Electronic Health Record\\r\\n\\tMust be able to maintain good inter-personal relationship with co-workers and other members of the health care team and the organization\\r\\n\\t&nbsp;Provide customer service in accordance with the organization&rsquo;s mission\\r\\n\\tBe courteous and respectful when interacting with patients and family members\\r\\n\\tMaintain patient confidentiality in accordance with organization policies, procedures, and HIPAA requirements\\r\\n\\r\\n\\r\\n&nbsp;\\r\\n\",\"experienceRequirements\":\"Education, Experience and Other Requirements:\\r\\n\\r\\n\\r\\n\\tHigh School diploma or equivalent\\r\\n\\tPrevious experience in a hospital and specialty clinic setting preferred\\r\\n\\tPrevious experience in orthopedic and neurological authorizations preferred\\r\\n\\tKnowledge of insurance processes and medical terminology required\\r\\n\\tSocial and cultural sensitivity appropriate to ethnically and economically diverse patient-and employee-base\\r\\n\\tCommunicates through appropriate channels. Use proper chain of command for patient complaints\\r\\n\\tAbility to handle emergency situations calmly and effectively\\r\\n\\tMust be computer literate and able to navigate through the Electronic Health Record\\r\\n\\tMust be able to maintain good inter-personal relationship with co-workers and other members of the health care team and the organization\\r\\n\\t&nbsp;Provide customer service in accordance with the organization&rsquo;s mission\\r\\n\\tBe courteous and respectful when interacting with patients and family members\\r\\n\\tMaintain patient confidentiality in accordance with organization policies, procedures, and HIPAA requirements\\r\\n\\r\\n\\r\\n&nbsp;\\r\\n\",\"validThrough\":\"-0001-11-30\"}",
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    "qualifications": "<p style=\"margin-bottom:11px\"><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"font-family:Calibri,sans-serif\"><b><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Education, Experience and Other Requirements:</span></span></b></span></span></span></p>\r\n\r\n<ul>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">High School diploma or equivalent</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Previous experience in a hospital and specialty clinic setting preferred</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Previous experience in orthopedic and neurological authorizations preferred</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Knowledge of insurance processes and medical terminology required</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Social and cultural sensitivity appropriate to ethnically and economically diverse patient-and employee-base</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Communicates through appropriate channels. Use proper chain of command for patient complaints</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Ability to handle emergency situations calmly and effectively</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Must be computer literate and able to navigate through the Electronic Health Record</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Must be able to maintain good inter-personal relationship with co-workers and other members of the health care team and the organization</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">&nbsp;Provide customer service in accordance with the organization&rsquo;s mission</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Be courteous and respectful when interacting with patients and family members</span></span></span></span></span></span></li>\r\n\t<li><span style=\"font-size:11pt\"><span style=\"line-height:normal\"><span style=\"vertical-align:baseline\"><span style=\"font-family:Calibri,sans-serif\"><span style=\"font-size:12.0pt\"><span style=\"font-family:&quot;Calibri Light&quot;,sans-serif\">Maintain patient confidentiality in accordance with organization policies, procedures, and HIPAA requirements</span></span></span></span></span></span></li>\r\n</ul>\r\n\r\n<p style=\"margin-left:48px\">&nbsp;</p>\r\n",
    "descriptionTitle": "Description",
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    "legalRevisionDate": {
      "date": "2025-05-12T13:08:42.000Z",
      "timezone": "America/Chicago",
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    "primaryPhoneCountry": "US",
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    "qualificationsTitle": "Qualifications",
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  },
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    "jobId": 801111,
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    "jobTitle": "Prior Authorization Specialist- Full Time- M-F- 9am-5pm",
    "postedOn": "",
    "locations": "Sheridan Community Hospital - Sheridan, MI 48884",
    "remoteType": "",
    "description": "Position: Prior Authorization Specialist\r\n\r\nReports To: Revenue Cycle Manager\r\n\r\nSchedule: Full time\r\n\r\nPosition Location/Department: Accounting\r\n\r\nJo...",
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