Authorization Specialist

At Therapy & Beyond we are passionate about empowering families and guiding our clients toward success! As an Authorization Specialist you will play a vital role in our mission by managing the full lifecycle of insurance verification and this key role youll help ensure seamless financial reimbursement by securing pre-authorizations obtaining retroactive approvals and maintaining active authorizations for ongoing care. Serving as a trusted liaison between our organization third-party payors and dedicated clinical team you will help minimize denials so our staff can focus on what matters most: delivering exceptional care.

JOB-SPECIFIC FUNCTIONS:

• Team Mentoring & Oversight: Provide guidance and support to team members on authorization processes best practices and payor requirements.

• Authorization Management: Initiate and secure initial benefits pre-authorizations and re-authorizations via payor portals fax or telephone.

• Follow-Up & Tracking: Strictly adhere to follow-up schedules (e.g. 3 7 14 30 days) based on payor guidelines to expedite claims and prevent revenue loss.

• Complex Case Resolution: Manage high-complexity requests including retroactive authorizations and Single Case Agreements (SCAs) for out-of-network patients.

• Data Integrity: Verify that authorization quantities CPT codes and effective dates are accurately entered into the practice management system.

• Clinical Collaboration: Coordinate directly with healthcare providers to secure necessary clinical notes letters of medical necessity and supporting documentation in a timely manner.

• Process Improvement: Develop and maintain a centralized Payor Master List and internal authorization manuals to standardize workflows and improve efficiency.

• Compliance: Review and interpret insurance group pre-certification requirements to ensure full compliance before services are rendered.

Qualifications :

• Education: Associates of Bachelors degree preferred in Healthcare Administration or related field preferred.

• Experience: Minimum of 2 years of experience in insurance verification medical billing or authorization management.

• Technical Skills: Proficiency with electronic medical records (EMR) systems and payor portals.

• Soft Skills: Strong written and verbal communication skills with the ability to build rapport with insurance representatives. Excellent organizational skills and attention to detail.

Additional Information :

• Generous benefit Package: 
• Medical Dental Vision and Disability
• Company Paid- Life Insurance
• 401K with company match
• Company Paid Short-Term Disability
• HSA and FSA options
• Employee Assistance Program 
• Employee Recognition

Remote Work :

No

Employment Type :

Full-time