Authorization Coordinator (Garlington Health Center)

Cascadia Health•Portland, OR

8d•Onsite

About The Position

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.

Requirements

High school diploma, GED, or equivalent is required.
Two years of work experience in an office setting , insurance or healthcare experience: or demonstrated ability to fulfill the requirements of the position.
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.
Ability to commute to various Cascadia sites and community locations as needed.

Nice To Haves

Qualifying as a QMHA (Qualified Mental Health Associate) is preferred.

Responsibilities

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.
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.

Benefits

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