Authorization Coordinator (Garlington Health Center)

Authorization Coordinator (Health Centers)

Job Overview

Location/Schedule: This position is located at the Garlington Health Center located in NE Portland, OR. The schedule is Monday through Friday, 8:30 a.m. to 5:00 p.m.

Position: Authorization Coordinator

Program: Health Centers

Cascadia’s Mission And Vision

Mission: Cascadia Health delivers whole health care – integrated mental health and addiction services, primary care, and housing – to promote hope and support the well-being of the communities we serve.

Vision: We envision a community where everyone benefits from whole health care, experiences well-being, and has a self-directed, connected life.

Position Description: The Authorization Coordinator provides administrative support essential to Cascadia Health’s trauma-informed approach. This position completes and submits service authorization and reauthorization requests for clients, appeals denials, and assists in correcting service documentation errors to prevent revenue loss. Working in collaboration with multiple departments, the Authorization Coordinator ensures that service utilization documentation aligns with Cascadia’s mission and supports the financial integrity of the organization.

Essential Responsibilities

This position description is not intended to be an all-inclusive list of responsibilities, skills, or working conditions associated with the position. Management reserves the right to modify, add or remove duties as necessary.

• 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 authorizations 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 client including insurance verification, updating insurance in EMR, and adding clients to teams, programs, episodes, GEO areas with EMR.
• Engage proactive review of service reports to identify and correct errors to ensure correct billing and prevent loss of revenue.
• Complete annual audits
• Scan authorization and clinical Documentation
• 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.
• 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 Responsibilities

• Monitor data accuracy and report problems to appropriate programs, departments or leadership.
• Provide back up for the Office Specialist positions as needed.
• Interact daily with clients for insurance, scheduling, payment process, paperwork, etc functions as needed.
• Is certified, or able to become certified, to assist clients apply for and interact with the Oregon Health Plan.
• To ensure billing accuracy, work with external systems such as, but not limited to, MMIS, CIM, Noridian, OneHealthPort, OPTUM, Trizetto,
• Serve as on-site point of contact for all self-pay functions including, but not limited to, adjudicating self-pay and hardship applications, tracking balances, reconciling accounts upon client discharge.
  
  

Qualifications

Education:

• High school diploma, GED, or equivalent is required.
• Qualifying as a QMHA (Qualified Mental Health Associate) is preferred.
  
  

Experience

• Two years of work experience in an office setting, insurance or healthcare experience: or demonstrated ability to fulfill the requirements of the position.
  
  

Specialized Knowledge, Skills And Abilities

• 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
• Strong verbal and written communication skills
  
  

Other

• Ability to commute to various Cascadia sites and community locations as needed.
  
  

Working Conditions

Work is generally performed in a shared work environment in a clinical office setting. 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. If you need assistance or accommodation due to a disability, contact us at 503-963-7654.

This position is represented by a labor union.

Benefits

We offer generous benefits for our full-time and part-time employees (20 hours pro-rated) including:

• Generous Paid Time Off Package Full-time employees earn 6 weeks of PTO in their first year!
• Medical and Dental Coverage (begins 1st of the month following hire date)
• VSP Vision Discount Plan
• 403(B) Retirement Savings (Pre and post-tax plans with up to 8% employer matching contribution!)
• Flexible Spending Account (FSA) (Medical, dependent care, and transportation options)
• Short-Term Disability, Long-Term Disability, and Life Insurance
• Paid Bereavement and Jury Duty Leave
• Length of Service Award
• Voluntary Life Insurance
• Supplemental Insurance
• Student loan forgiveness options
  
  

Wellness Benefits

• Employee Assistance Program (EAP)
• Bike to Work Reimbursement
• Discounted Fitness Memberships
• Trauma Support Team
  
  

Starting Rate Range in USD ($)

$23.57 - $24.37