Insurance Authorization Supervisor

Revive Bhs Llc•Severna Park, MD

8d•$65,000 - $75,000•Remote

About The Position

Revive BHS is seeking an experienced and detail-oriented Insurance Authorization Supervisor to oversee our insurance verification and authorization operations. This individual will be responsible for managing the authorization team, ensuring timely submission and approval of initial and concurrent authorizations, maintaining compliance with payer requirements, and supporting efficient reimbursement for our behavioral health clients. The ideal candidate will have extensive experience with behavioral health insurance authorizations, including substance use disorder and mental health levels of care, and a strong understanding of commercial insurance, Medicaid, managed care organizations (MCOs), and utilization management processes. This is a hands-on supervisory role requiring strong leadership, organization, problem-solving skills, and the ability to manage authorization workflows across multiple clients and payer systems.

Requirements

Minimum of 3 years of experience in insurance authorizations, utilization management coordination, or revenue cycle management within the behavioral health industry.
Previous supervisory, team lead, or management experience.
Strong working knowledge of substance use disorder and mental health treatment services, including residential, PHP, IOP, and outpatient levels of care.
Experience working with commercial insurance carriers, Medicaid, and Medicaid managed care organizations.
Demonstrated experience managing initial and concurrent authorization requests, tracking approved units, and resolving authorization denials.
Familiarity with medical necessity criteria, including ASAM Criteria and payer-specific utilization management guidelines.
Proficiency with insurance payer portals, EHR systems, and authorization tracking tools.
Strong organizational, analytical, communication, and problem-solving skills.
Ability to manage competing priorities, meet strict deadlines, and oversee multiple client accounts.

Nice To Haves

Experience working with behavioral health providers across multiple states.
Familiarity with major commercial payers, including Aetna, Anthem/BCBS, Cigna, UnitedHealthcare/Optum, and regional Medicaid MCOs.
Experience developing standard operating procedures, quality assurance processes, and team performance metrics.
Knowledge of behavioral health billing, claims processing, denial management, and reimbursement workflows.
Experience with substance use disorder residential and withdrawal management authorization processes.
Familiarity with electronic health record platforms commonly used in behavioral health treatment settings.

Responsibilities

Supervise, train, and support insurance authorization and verification specialists.
Manage daily workloads, staff assignments, productivity, and overall team performance.
Establish and maintain standardized authorization procedures and workflows.
Monitor staff performance, identify training opportunities, and provide ongoing coaching.
Serve as the primary escalation point for complex authorization issues, payer disputes, and urgent requests.
Ensure consistent communication and coordination between authorization specialists, billing teams, and client organizations.
Oversee the timely submission, tracking, and follow-up of initial, concurrent, and continued-stay authorization requests.
Ensure authorizations are obtained and maintained for applicable behavioral health services, including residential treatment, partial hospitalization (PHP), intensive outpatient (IOP), and outpatient services.
Monitor authorization expiration dates, approved units, service limitations, and continued-stay requirements to prevent gaps in coverage.
Review authorization requests for accuracy, completeness, and compliance with payer-specific requirements.
Coordinate with clinical teams to obtain supporting documentation, medical necessity information, and other materials required for authorization.
Manage authorization denials, reconsiderations, appeals, and peer-to-peer review coordination.
Identify and resolve authorization barriers that could delay treatment or reimbursement.
Maintain familiarity with payer-specific authorization requirements, submission platforms, and clinical review processes.
Oversee insurance verification and benefits investigation processes to ensure accurate identification of patient coverage.
Ensure verification of eligibility, behavioral health benefits, authorization requirements, deductibles, copayments, coinsurance, and applicable coverage limitations.
Identify potential coverage issues, out-of-network restrictions, and payer-specific reimbursement concerns.
Ensure accurate documentation of verification findings and communication of financial responsibility information to appropriate teams.
Collaborate with billing and collections teams to identify and resolve authorization-related claim denials.
Monitor authorization-related denial trends and implement corrective action plans.
Conduct routine quality assurance reviews of authorization records, documentation, and staff performance.
Develop and maintain tracking systems and reports for authorization status, turnaround times, denials, and outstanding requests.
Ensure accurate and timely documentation within electronic health record (EHR) systems, payer portals, and internal tracking platforms.
Identify opportunities to improve workflows, reduce administrative delays, and increase operational efficiency.
Maintain compliance with HIPAA, payer requirements, and applicable federal and state regulations.