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

SHERIDAN COMMUNITY HOSPITAL • Sheridan, MI

4d • Onsite

About The Position

Sheridan Community Hospital is seeking a Prior Authorization Specialist with hospital facility experience to support our revenue cycle team. In this role, you will play a critical part in ensuring patients receive timely access to care by securing authorizations for procedures, admissions, and specialty services. This is a high-impact position where your work directly affects patient outcomes, provider workflow, and hospital revenue integrity. Sheridan offers a better balance compared to larger health systems: Approximately 45 minutes from Grand Rapids Metro, Approximately 60 minutes from Lansing, MI. Easy commute with less congestion. Close-knit, team-oriented hospital environment. Many team members choose Sheridan for a more manageable pace and stronger collaboration while living in nearby cities. 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.

Requirements

• Hospital facility experience REQUIRED (not clinic-only)
• High school diploma or equivalent required
• Strong knowledge of: Insurance authorization processes, Medical terminology, Healthcare workflows
• Proficiency in EHR systems and computer applications
• Strong attention to detail and organizational skills
• Ability to manage urgent requests and prioritize effectively
• Excellent communication and teamwork skills

Nice To Haves

• Experience in orthopedic and/or neurological authorizations preferred

Responsibilities

• Manage and track incoming authorization requests via EHR, email, phone, and fax
• Submit prior authorizations and supporting clinical documentation to insurance carriers
• Coordinate with physicians, specialists, and internal departments
• Review medical necessity and ensure complete, accurate documentation
• Prioritize requests based on patient urgency and service timelines
• Follow up with payers to ensure timely approvals and prevent delays in care
• Document all communication and status updates in the EHR
• Assist with denial review and collaborate with coding/billing teams on appeals
• Support referral authorization processes as needed
• Maintain compliance with HIPAA and organizational policies
• Participate in quality improvement initiatives

Benefits

• Paid Time Off (PTO)
• Paid Holidays
• Medical Insurance (multiple plan options)
• Dental Insurance
• Vision Insurance
• Employer-paid Life Insurance
• 401(k) with employer match
• Tuition/Continuing Education Reimbursement
• Employee Health Hospital Discount

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED