Prior Authorization Specialist

Job Summary

Reporting to the Clinical Director and working closely with the Clinical Team, this role plays a key part in ensuring the financial health of the organization. The position serves as a vital link between patients with mental health and/or substance use disorders and insurance providers, healthcare services, and billing operations. It is essential to the success of the companys programs.

Key Responsibilities

Therapy/IOP Prior Authorizations (PARs)

• Confirm insurance coverage
• Monitor and track therapy sessions weekly
• Coordinate with therapists to obtain necessary documentation
• Prepare and submit PARs
• Upload and organize submissions; maintain tracking sheets
• Notify RMH Manager and therapists of authorization outcomes

Residential Mental Health (RMH) PARs

• Verify insurance eligibility
• Complete and submit RMH PARs
• Upload and organiz...