Billing and Authorization Specialist
Center for Human Development (CHD)•West Springfield, MA
•Onsite
About The Position
The Center for Human Development (CHD) is seeking a Billing and Authorization Specialist for our In-Home Therapy & Therapeutic Mentoring programs. This position is located in West Springfield, serving children and families across Hampden, Hampshire, Franklin, and Worcester Counties. The Billing and Authorization Specialist acts as a key liaison between the revenue cycle management team and clinical program staff, facilitating communication around authorizations, medical necessity requirements, and payer protocols.
Requirements
- High school diploma or equivalent required.
- Must have 3-5 year of experience in front-end revenue cycle within a healthcare setting, with a strong focus on authorizations.
- Experience with electronic health records (EHR) systems, including document attachment and digital file organization.
- Experience with Payer portals, including eligibility verification and securing authorizations.
- All candidates must complete and pass background record screening.
Nice To Haves
- Previous experience with EHR systems.
- Proficiency with Microsoft Office suite, specifically with strong capabilities in excel.
- Strong communicator that approaches interactions with management and clinical staff in a pleasant and professional manner.
Responsibilities
- Provide critical support to clinical authorization workflows, ensuring compliance with payer requirements and timely submission of authorization requests.
- Monitor authorization statuses, track expirations, and initiate re-authorization processes as needed.
- Data and report maintenance with weekly tracking for all service lines which require an authorization.
- Coordinate and manage the technical billing ticketing system, triaging requests to either outsourced teams or internal departments for efficient resolution.
- Assist with the input and maintenance of referring provider data within the EHR system.
- Navigate payer websites and technical resources to assist with user access, ensuring that program, clinical staff, outsourced agencies, all have the necessary information and tools to resolve issues.
- Provide cross-coverage for various internal CHD revenue cycle tasks, ensuring seamless operational continuity.
- Administrate duties to include, but are not limited to: Answering calls, making calls, ordering supplies, coordinating meetings etc.
Benefits
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Earned vacation time
- Paid holidays
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
1-10 employees
