Authorization Specialist

All Together Recovery•Danville, KY

3d•Onsite

About The Position

All Together Recovery LLC (ATR), provides multiple levels of ASAM SUD/BHSO care, including recovery housing, education, job training, employment, and other recovery related extensions to the family in for-profit and non-profit environments. The Authorization Specialist is responsible for obtaining, tracking, and maintaining insurance authorizations for patient services to ensure timely access to care and proper reimbursement. This role serves as a key liaison between clinical teams, insurance payers, and administrative staff, ensuring compliance with payer requirements and minimizing authorization-related denials or delays.

Requirements

The applicant must have a minimum of a high school diploma or GED.
Minimum of 2-3 years’ experience in SUD authorizations, utilization review, or behavioral health billing.
Must have knowledge of medical privacy and confidentiality (Health Insurance Portability and Accountability act (HIPAA)
Must have computer applications/software to include Microsoft Office programs/MS outlook (e-mail), and internet familiarity, along with Dropbox and EHR is preferred.
Must have the knowledge, skills, and abilities to perform the essential functions of the job.
Must have excellent customer service skills.
Must have organizational skills with attention to detail.
Must have strong communication skills both verbal and written
Maintain effective interpersonal relationships.
Must have the ability to work independently, and in a demanding and busy environment.
Must have the ability to multitask and have a proficient handle on completing tasks within an assigned timeframe.
Must be able to work well with other staff and clients.
Minimum of 40 hours per week.

Nice To Haves

An associate degree is preferred but not required.
Experience working in behavioral health field strongly preferred.
Previous experience working with KIPU, CollabMD, Availity, KYMMIS, and payer portals strongly preferred.
Experience working with individuals and families who have various mental, behavioral, and substance use conditions.

Responsibilities

Obtain initial insurance authorizations for assigned levels of care (e.g., 3.1 & 3.5 residential, PHP, IOP, outpatient) by submitting authorization requests to Medicaid and commercial payers via portals, fax, or phone.
Track authorization start/end dates, approved days, and service limitations.
Communicate authorization determinations, extensions, and denials to clinical, medical, and billing teams.
Coordinate with clinical and medical staff to gather required documentation for concurrent reviews.
Monitor census and authorization expirations to prevent lapses in coverage.
Maintain accurate authorization records in the EHR and payer portals.
Follow up on pending authorizations and escalate urgent cases affecting patient care to the Business Office Manager.
Assist with appeals and retro-authorizations related to authorization denials.
Ensure compliance with payer guidelines, state regulations, and internal policies.
Scan, upload, and organize authorization correspondence and payer communications.
Cross train with initial claim submission and claim denial management to ensure continuity of care for patients.
Support coverage during staffing shortages, downtime, or high-volume periods, within scope of training.
Develop working knowledge of billing workflows, claim submission processes, and payer requirements related to authorized services.
Assist with answering incoming phone calls and direct to appropriate departments
Assist with other duties as assigned by Business Office Manager