Authorization Specialist

Claratel Behavioral Health • Decatur, GA

3d • Onsite

About The Position

The Authorization Specialist will be responsible for the daily processing of all authorization files/requests on a daily basis. Works closely with each clinician on any requests that are on review. Ensures all behavioral health programs are obtaining and submitting authorizations in a timely fashion. Assists clinicians with questions or concerns they may have regarding authorizations. Oversees and works on all authorization related issues. Conducts training on CMO authorizations, ASO related issues, coding/billing updates and eligibility issues. Creates reports for managerial staff to summarize errors.

Requirements

• Demonstrate overall knowledge of authorization and claims processing for insurance companies and plans both private and government.
• Demonstrate the ability to make decisions, assess, and resolve problems effectively.
• Demonstrates the ability to maintain the confidentially of all records
• Demonstrated ability to manage multiple tasks and demands given tight times constraints while ensuring a high degree of accuracy and attention to detail.
• Effective interpersonal skills in a diverse population
• Ability to interpret and apply agency policies and procedures
• Ability to communicate effectively, both orally and written
• Ability to establish and maintain effective working relationships with others
• Completion of an associate’s degree from an accredited college or two years of related experience
• Experience with SFTP protocols
• Microsoft Excel- creating spreadsheets, filtering, and pivot tables
• Microsoft Word- creating error templates and documentation

Responsibilities

• Coordinate/manage all ASO and Care Management Organization (CMO) authorization requests for DeKalb CSB
• Oversees the authorization process end to end making changes as identified and resolving of billing discrepancies
• Electronically submits, receives, and process data on a daily basic. Analyzes reports and correct errors and/or inform appropriate staff of error to be corrected and re-submit
• Review documentation and coordinate with clinical team members to ensure the State and CMO clinical requirements/standards are being met
• Coordinate with the UM Manager regarding any authorization reviews and appeals
• Use advanced tools to analyze data and conduct comprehensive clerical research using a variety of resources to generate reports and responds to requests
• Enter data from forms, records, and/or reports using a computer or terminal. Code information as appropriate

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree