Authorization Specialist (54226)

POSITION SUMMARY:

The Behavioral Health Authorization Specialist is responsible for coordinating and securing prior authorizations and continued service approvals for mental health and substance use treatment services. This role supports clinical and administrative teams by ensuring timely communication with insurance providers, compliance with payer guidelines, and prevention of service delays due to authorization issues.

DUTIES AND RESPONSIBILITIES:

Obtain and manage pre-authorizations and concurrent review approvals for behavioral health services

• Verify insurance coverage and eligibility for mental health and substance use disorder treatment.
• Collaborate with clinicians and case managers to ensure documentation meets payer requirements for medical necessity.
• Communicate with insurance providers, managed care organizations, and third-party payers to secure authorizations and resolve discrepancies.
• Maintain accurate and timely records of all authorization activities in the EHR system.
• Monitor authorization expiration dates and coordinate reauthorization or continued stay reviews as needed.
• Notify clinical and billing departments of any issues or denials that may impact care or reimbursement.
• Stay current on insurance regulations, behavioral health benefit structures, and prior authorization policies.
• Other duties as assigned.

QUALIFICATIONS:

Must have great problem-solving skills, strong typing skills, excellent written and oral communication skills, strong service orientation, flexible and adaptable to quick changing environment(s), and have the ability to work as a team player.

Minimum high school diploma or GED required. Minimum 1-2 years experience in behavioral health setting preferred. Minimum 1-2 years experience using an electronic health record preferred. Experience working with major payers including Medicaid, Medicare and commercial insurance plans is preferred.

CORE VALUES:

All employees must be willing to live our company's core values.

• Integrity – Exhibiting the highest moral, ethical and legal standards. Doing the right thing – even when no one else is looking.
• Teamwork – Putting team success over personal success. Actively valuing the strengths and talents of others.
• Trust/Respect– Seeing and believing in the good intentions of others. Interacting with others in a way that makes them feel valued. Listening without judging. Offering understanding and acceptance.
• Care/Compassion – Demonstrating unconditional kindness, concern and empathy. Exhibiting genuine concern for others.
• Ownership/Accountability – Taking personal responsibility for one’s work, actions and feelings. Accepting responsibility for and learning from mistakes.

Salary : $18