Behavioral Health Authorization Coordinator - Behav Hlt O/P

According to the National Institute of Mental Health, an estimated 26.2 percent of adults suffer from a diagnosable mental disorder. Recognizing this need, we at Lakeland Regional Health have devoted ourselves in creating the best mental health facilities possible. We are dedicated to improving outcomes and helping people get well. From helping children and parents survive divorce, to treating depression, our licensed clinical staff provides a team approach to care. Under the direction of a board-certified psychiatrist, our mental health facilities provide in- and out-patient care to adults at all levels of mental health severity. Under the direction of our board-certified child and adolescent psychiatrist, we also provide services to adolescents who require mental health treatment. If you have a heart for those suffering from mental health disorders, please consider joining our mental health department. We have the following opportunity:

Work Type: Active - Benefit Eligible and Accrues Time Off
Exempt: No

Work Schedule: Monday - Friday
Work Hours per Biweekly Pay Period: 80.00

Shift Time: 8:30 AM - 5:00 PM
Location: Behavioral Health, Medical Center - Lakeland, FL

Summary:
The Behavioral Health Authorization Coordinator serves in the critical role of assisting patients with getting timely access to behavioral health services that require prior authorization from their insurance carrier. This individual will collaborate with patients and our clinical team to gather the required information and submit to insurance companies for review.

Detailed responsibilities:
* People At The Heart Of All We Do
- Fosters an inclusive and engaged environment through teamwork and collaboration.
- Ensures patients and families have the best possible experiences across the continuum of care.
- Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.
* Safety And Performance Improvement
- Behaves in a mindful manner focused on self, patient, visitor, and team safety.
- Demonstrates accountability and commitment to quality work.
- Participates actively in process improvement and adoption of standard work.
* Stewardship
- Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
- Knows and adheres to organizational and department policies and procedures.
* Standard Work: Behavioral Health Authorization Coordinator
- Proficient critical thinking and problem-solving skills to obtain timely authorizations for behavioral health services
- Develops a systematic and analytical approach to obtaining prior authorizations for behavioral health services by keeping track of each payor’s medical necessity submission requirements
- Develops and maintains collaborative partnerships with insurance care managers and community agencies to provide patients with expedited access to behavioral health services.
- Validates accuracy of insurance enrollment information in the system before requesting treatment authorization
- Collects and sends the required clinical documentation to third-party payors in a timely manner to obtain treatment authorization
- Provides regular updates to the treatment team and patient schedulers regarding the status of prior authorizations
- Assists patients with understanding their benefits coverage and payment responsibilities
- Collaborates regularly with internal and community providers to facilitate smooth transitions of care and efficient collection of appropriate referrals for services requiring prior authorizations
- Tracks low balance of authorizations on patient accounts and proactively initiates new authorizations as directed by the treating provider
- Function as a member of the revenue cycle team to ensure that all daily responsibilities are met
- Respond to insurance denials through the appeals process when appropriate
- Participate in continuing professional education with both behavioral health and revenue cycle departments
- Assist with telephone scheduling of behavioral health appointments as needed.
- Perform other duties as assigned or required

Education:
Essential:
* High School or Equivalent
Nonessential:
* Bachelor Degree

Education equivalent experience:
Nonessential:
* Psychology, Social Work, Human Services, or other relevant degree

Other information:
Experience Essential:
-At least two years working with electronic health record systems and insurance portals
-At least two years of experience of successfully obtaining timely authorizations, patient registration, and/or revenue cycle
-At least two years of experience working in a behavioral health clinic setting
Experience Preferred:
-Three years working in a role that successfully processed prior authorization paperwork for medical or behavioral services