Authorization Representative - Oncology

Embark on a rewarding career with DMC Huron Valley-Sinai Hospital. If you are a compassionate healthcare professional eager to contribute to patient care, this is your opportunity where your skills make a difference every day. Join us in delivering exceptional healthcare with a personal touch.

Benefits Statement

At Tenet Healthcare, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:
• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off (PTO)
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.

Note: Eligibility for benefits may vary by location and is determined by employment status

Job Summary

Under general supervision is responsible for securing and tracking authorizations/referrals through patient's length of stay or visit. Assures authorizations/referrals and re-authorizations are obtained and secured for hospital and clinic patients. Participates in the care and customer service process by ensuring all authorizations have been received. Assures appropriate verified insurance information has been updated in SMS registration pathways to ensure timely payment and to meet clean claim requirements. Coordinates with outside eligibility vendor and Clinical Resource Management as necessary using established criteria. Obtains financial approvals and supporting documentation for internal financial assistance programs, updates the registration pathways with approval or denial information. Interprets Managed Care contracts and other third party payer contacts in order to secure correct authorization and/or referral. Downloads and updates Dedicated Authorization log on a daily basis. Provides various reports to management.

Embark on a rewarding career with DMC Huron Valley-Sinai Hospital. If you are a compassionate healthcare professional eager to contribute to patient care, this is your opportunity where your skills make a difference every day. Join us in delivering exceptional healthcare with a personal touch.

Benefits Statement

At Tenet Healthcare, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:
• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off (PTO)
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.

Note: Eligibility for benefits may vary by location and is determined by employment status

Job Summary

Under general supervision is responsible for securing and tracking authorizations/referrals through patient's length of stay or visit. Assures authorizations/referrals and re-authorizations are obtained and secured for hospital and clinic patients. Participates in the care and customer service process by ensuring all authorizations have been received. Assures appropriate verified insurance information has been updated in SMS registration pathways to ensure timely payment and to meet clean claim requirements. Coordinates with outside eligibility vendor and Clinical Resource Management as necessary using established criteria. Obtains financial approvals and supporting documentation for internal financial assistance programs, updates the registration pathways with approval or denial information. Interprets Managed Care contracts and other third party payer contacts in order to secure correct authorization and/or referral. Downloads and updates Dedicated Authorization log on a daily basis. Provides various reports to management.

• High School diploma or equivalent. Associate degree in finance or business administration highly desirable.

• Four or more years of prior work experience in patient registration, patient accounting and knowledge of third party payors.

• Familiarity with medical terminology and concepts.

• Working knowledge with third party insurance verification, respective systems, authorization, referral procedures and clinical care process internal and external.

• Comprehensive knowledge of patient access process.

• Working knowledge of Michigan based Managed Care programs.

Skills Required

• Ability to understand and apply various third party payor requirements, verifications procedures and insurance benefit knowledge.

• Strong customer service orientation skills necessary to deal effectively with various levels of hospital staff, to communicate with diverse populations, and to relay sensitive and confidential information to patients, internal staff and a variety of external organizations.

• Excellent verbal and people skills; strong face-to-face communicator.