Authorization Specialist

  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.       DUTIES & RESPONSIBILITIES:    Under general supervision, incumbent duties and responsibilities will include but is not limited to the following:   • 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        SKILLS AND EDUCATION 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