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Upper Great Lakes Family Health Center Prior Authorization (PA) Specialist, 1.0 in Open, Michigan

Prior Authorization (PA) Specialist, 1.0

FLSA Status: Non-Exempt

Department: Clinic Support

Location: Open, Michigan

Employment Status: Full-time

FTE: 1.0 (80 hours bi-weekly)

Physical Work Location: Open


The Prior Authorization (PA) Specialist is primarily responsible for processing prior authorizations requests with insurance companies for patient visits, services, durable medical equipment (DME), and medications. The PA Specialist must effectively communicate with patients, care team, insurance companies, specialists, and insurance companies to ensure timely connection of the patient to their healthcare needs. This position will serve multiple clinics and can be performed from any clinic location.

Education, Training, Licensing and Credentialing


  • High School Diploma or equivalent


  • Certificate in medical office administration or similar course of study

  • Coursework or focused training in medical and insurance-specific terminology

Experience and Skills


  • Professional and friendly demeanor

  • Demonstrated verbal and written communication skills

  • Proficient typing and computer skills including experience using email

  • Ability to problem solve, multi-task, and prioritize work


  • Previous work experience in an office environment or customer service role

  • Prior experience working with confidential information

  • Experience working in healthcare or medical insurance field

  • Prior experience using eClinical Works or an Electronic Health Record

  • Experience using Microsoft Office Suite including Excel, Word, and PowerPoint

  • Experience working in a call center, as a receptionist, or similar clerical role

Physical Demands, Working Conditions and Travel Requirements

Physical Demands:

  • Occasional pushing, pulling, or lifting items up to 20 pounds, using proper body mechanics

  • Infrequent overhead lifting of objects up to 10 pounds

  • Occasional lifting or carrying objects up to 20 pounds

  • Frequent sitting for long periods of time

  • Frequent use of hands and fingers / manual dexterity and hand eye coordination consistent with typing, operating a computer, telephone, and general office equipment

  • Hearing and vision acuity necessary to perform most duties, including color vision and ability to focus

  • Frequent talking by phone

Working Conditions:

  • May work independently and/or in a group setting without direct supervision

  • Must have reasonable flexibility with hours of work to serve the needs of the clinic and patient populations served and occasional meetings outside of the normal clinic hours

  • Regular communication with patients, families, caregivers and member of the healthcare team.

  • Subject to many interruptions, changes in processes, and priorities

  • Potential exposure to communicable disease, bodily fluids, and substances typically found in a clinic environment

  • May require dealing with difficult and unpredictable situations and individuals

  • May have future workplace flexibility, including potential consideration of remote work for the right individual

Travel Requirements

  • Infrequent locally and regionally

Mental and Environmental Requirements

  • Requires continuous performance of detailed repetitive tasks, as well as changing priorities, and subject to frequent interruptions

  • Subject to work under stressful conditions primarily due to multiple calls, inquiries, and priorities

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