This position is located at our 1818 Building in SE Portland. The schedule for this position is Monday through Friday, 8:30 a.m. to 5:00 p.m. This is a hybrid position that works in the office two days per week. 

The Residential Authorization Coordinator will report to and work closely with the Residential Authorization Manager to assure that Cascadia client services documentation meets medical necessity and appropriateness of proposed care criteria. The individual in this position will complete and submit all service authorization and re-authorization requests for residential clients, appeal denials, and assist with correction of service documentation errors to prevent revenue loss within the residential programs. The individual in this position will also assist with other residential documentation tasks including completion of admit and discharge processes within the electronic health record for residential clients. This position will report to the Residential Authorization Manager who will assign workflows and assist with these duties.

All incumbents must understand, appreciate, and respect the diversity and cultural differences within our Cascadia community. It is expected that there is an awareness and sensitivity to the perspectives and perceptions to those we serve, as well as our colleagues. As Cascadia is Trauma informed, the incumbent must support a Trauma Informed Care Environment. With the high prevalence of trauma among individuals receiving behavioral health services, it is required that the incumbent understand the effects of trauma on health, coping, and other aspects of the lives of those we serve.

On the first of the month, following 60 days of employment, benefit eligible employees (20/hrs. or more per week) are able to enjoy affordable, low cost, medical, dental, and vision benefits. Additionally, Cascadia provides a generous paid time off package, volunteer time off, and more. Upon hire, you will complete paid training and then continue to train onsite in your new job. During the first week of training, you will learn about the agency, understanding those we serve, Trauma informed care, and other skills to prepare you for significant and meaningful work in the behavioral health field, whether you are providing clinical services or non-direct services. Click here to learn about the benefits we offer and more. 

Essential Duties:

• Complete all aspects of service utilization documentation within all programs from client enrollment through discharge
• Assist in tracking the approval process for all documents submitted. Assist in identifying denials and completing denial appeal process to ensure capture of all possible revenue to the programs.
• Work directly with leadership and clinicians as needed to obtain information to complete document submission and/or denial appeal processes in a timely manner.
• Work with various external stakeholders to appeal denials of service authorization or submit memos requesting extensions to authorizations as needed.
• Engage in proactive, regular review of insurance systems to identify activity on submissions and catch denials.
• Ensure completion of all enrollment information for each new residential client including insurance verification, updating insurance in EHR, adding clients to teams, programs, episodes, GEO areas within the EHR.
• Engage in proactive review of service reports to identify and correct errors to ensure correct billing and prevent loss of revenue.
• Complete annual audits
• Will work within a variety of electronic systems such as MMIS, CIM, EHR, to gather relevant client information, verify insurance, identify denials, enter information to obtain authorizations, etc.
• Assist with reconciliation of service errors to prevent revenue loss.
• Proactively identify problem areas and assist to identify solutions.
• Maintain an understanding of financial needs, procedures and tasks.
• Maintain understanding of clinical records guidelines.
• Collaborate with other sites as needed to address records issues.
• Work in collaboration with multiple departments across the agency to ensure adherence to Cascadia’s stated mission, vision and values.
• Scan authorization and clinical documentation.
• Adhere to mandatory abuse reporting laws and HIPAA requirements.
• Provide input on all relevant documentation and procedural requirements
• Complete annual employee training requirements on a timely basis
• Attend meetings as necessary
• Perform other duties as assigned.

Program Specific

• Coordinate with the financial department and maintain the Choice Model programs monthly “workbook,” tracking an accounting of finances that are funded by State and County entities. 
• Complete and submit Prior Authorization (PA) requests, Plans of Care (POC), Retainer Payment requests and outpatient case rate authorizations.
• Provide availability to all Residential Managers for daily assistance in problem solving large and complex operational issues.
• Make independent decisions for urgent issues that may affect multiple sites
• Twice a year provide bed board, scanning and audit training to all residential staff
• Review resident status logs weekly and update bed boards as needed
• Complete and submit Capacity reports for all residential sites to the state weekly
• Keep office equipment prepped for use
• Organize and maintain office supplies and supply area

Qualification:

• The incumbent must have a high school diploma, GED or equivalent
• A Qualified Mental Health Associate is preferred (QMHA). To be a QMHA, one must must have a Bachelor’s Degree in a behavioral science field from an accredited college or university or three years of mental health work experience or a combination of work experience and education. Certification must be current and in compliance with MHACBO.
• Two years’ experience in administrative coordination in a healthcare setting is preferred
• Advanced Word processing and Excel skills, intermediate database skills
• Ability to interpret the OARs and or knowledge of
• Type 50 wpm
• Familiarity with basic office equipment, i.e., fax machines, printers, copiers
• Proficiency in computer hardware and software at a level to effectively perform the job functions
• Accurate typing and data entry skills
• Ability to commute to various Cascadia sites and community locations as needed.

Working Conditions:

• Environmental: Work is performed in a shared work environment in a clinical offices setting.
• Operational Hours: Occasional overtime may be necessary. Work hours are typically standard business hours, Monday through Friday, 8:30 am-5:00 pm.
• Mental Demands: The work assigned is diverse and involves addressing new and unusual circumstances in which outcomes may negatively affect costs, employee morale or clients. The work regularly involves a degree of unpredictability and disruption of planned tasks requiring a flexible time management approach.
• Physical Demands: The nature of work requires extended periods of sitting and standing. The majority of work is done utilizing a computer and keyboard. The Authorization Coordinator may have to assist the team in providing safety to all clients and staff in potentially volatile situations.

Cascadia is an Equal Opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. If you need assistance or an accommodation due to a disability, you may contact us at 503.963.7654 or at peopleandculture@cascadiabhc.org