Residential Authorization and Insurance Specialist

3 days ago


Covington, Kentucky, United States Hire Velocity Full time
{"Job Summary

We are seeking a highly skilled Authorization and Utilization Review Specialist to join our team at Hire Velocity. This role is responsible for ensuring seamless authorization and utilization processes for our residential services programs.


Key Responsibilities
  • Verify insurance coverage and benefits for clients, ensuring accurate and timely documentation in the CareLogic EHR system.
  • Complete prior authorization requirements for insurance companies, ensuring compliance with policies and regulations.
  • Provide expert guidance on VOBs (verification of benefits) to advise the team on policies that will not pay enough to cover daily operation costs.
  • Track concurrent reviews to ensure proper documentation is present to advocate for clients to receive the highest level of care.
  • Collaborate with the clinical team to provide feedback on insurance case managers, documentation requirements, and language/jargon to ensure optimal care.
  • Support the Director of Admissions with authorization and utilization reviews, ensuring seamless transitions and communication.
  • Participate in agency Performance Quality Improvement and Quality Assurance Committee activities, driving continuous improvement and excellence.

Requirements
  • Minimum of 2 years' experience as an authorization/utilization review specialist in adolescent substance use and/or behavioral health facilities.
  • Familiarity with residential behavioral health services and the CareLogic EHR system.
  • Strong verbal and written communication skills, with the ability to build relationships with insurance companies and case managers.
  • Above-average organizational and time management skills, with great attention to detail.
  • Alignment with the Sanctuary Institute's trauma-informed care model and the Human Rights Campaign's All Children All Families initiative in LGBTQ+ competencies.
  • Demonstrated sensitivity to the various cultural and socioeconomic characteristics of clients and staff.

What We Offer
  • Thirty-seven paid days off, including 13 paid holidays and 18 days of PTO.
  • Four weeks of paid family leave after 1 year of employment.
  • Student Loan Repayment Assistance up to $10,000 over the course of employment.
  • Tuition Reimbursement of up to $5,000 per year.
  • Retirement Plan with 6% employer match.
  • Medical Plan with Zero Deductible.
  • Dental, Life, LTD, STD, and Vision benefits.
  • Flexible Spending Account.
  • Employee Assistance Program.
  • Free Parking.
  • Dog-friendly environment at some locations.

CHNK is an Equal Opportunity Employer.

"}

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