Authorization & QA Coordinator

Advocate Support Services Inc•Annapolis, MD

1d•Onsite

About The Position

The Quality Assurance & Authorization Coordinator is responsible for ensuring regulatory compliance, overseeing authorization processes, and supporting quality assurance initiatives within an off-site psychiatric rehabilitation program. This role plays a critical part in maintaining program integrity, optimizing service delivery, and ensuring adherence to all applicable state, federal, and accreditation standards. The ideal candidate is highly detail-oriented, organized, and knowledgeable in behavioral health compliance and authorization procedures.

Requirements

Associate’s degree in a related field (e.g., healthcare administration, psychology, social work) or equivalent experience required
Active CPRP
Minimum of 2 years of experience in a healthcare setting, preferably in quality assurance, compliance, and/or authorization
Strong knowledge of healthcare regulations, compliance standards, and authorization processes
Excellent organizational, analytical, problem-solving skills, and task prioritization
Effective communication and interpersonal abilities
Ability to manage multiple priorities and meet deadlines in a fast-paced environment
Proficiency in Microsoft Office, Apple products, and electronic health record systems
High attention to detail and accuracy
Confidentiality and ethical practices

Nice To Haves

Experience in behavioral health or psychiatric rehabilitation programs strongly preferred
Knowledge of COMAR 10.63, HIPAA, and CARD standards strongly preferred

Responsibilities

Monitor and ensure ongoing compliance with all applicable regulations and standards, including HIPAA, Maryland state regulations, and CARF requirements
Maintain quality assurance processes and internal audits
Identify compliance risks and partner with leadership to implement corrective action plans
Track, analyze, and report quality metrics and program performance indicators
Oversee the authorization process for services, ensuring timely submissions and approvals
Verify insurance eligibility and coordinate with Maryland Administrative Service Organizations
Maintain documentation supporting medical necessity and service authorization
Monitor authorization trends and proactively address denials or delays
Provide training and ongoing support to staff on documentation standards, compliance requirements, and authorization procedures
Serve as a resource for regulatory and quality-related questions
Collaborate with clinical and administrative leadership to improve workflow efficiency and service quality
Participate in performance improvement initiatives and program evaluations
Support audits, site visits, and accreditation reviews
Ensure all records are accurate, complete, and audit-ready
Maintain organized tracking systems for authorizations, compliance metrics, and QA activities