Service Authorization Specialist

3 weeks ago


Philadelphia, Pennsylvania, United States Comhar Inc. Full time
Service Authorization Technician Job Summary

COMHAR's Intensive Behavioral Health Services (IBHS) is a leading provider of mental, emotional, and behavioral health services for children, youth, and young adults in the Philadelphia area. As a Service Authorization Technician, you will play a critical role in ensuring the smooth operation of our services.

Key Responsibilities
  • Admit clients by gathering and recording provider, client, and insurance information.
  • Oversee the preauthorization and referrals process for the IBHS program.
  • Ensure that billing authorizations are uploaded from CBH and correctly inputted into EVOLV.
  • Process client admissions, track discharges, and submit to CBH to end active authorizations.
  • Pre-admit clients by receiving referrals from various sources and entering client information into the referral module in Evolv.
  • Run initial eligibility through Promise for clients.
  • Secure payments by screening insurance information, identifying clients requiring pre-admission approvals from third-party payers, and verifying approvals.
  • Upload and download CBH authorizations.
  • Develop and monitor authorization reports reviewed with the Office Manager.
  • Track and correct authorizations for proper length and number of units.
  • Meet weekly with CBH Care Manager to discuss authorization correction lists.
  • Document to ensure service hours and units match requested amounts.
  • Process contractor and temp agency invoices.
  • Ensure a responsive system for authorization of services and payment of claims by monitoring the COMHAR billing system for laps in service, rejections, and error logs.
Requirements
  • High school diploma or GED.
  • 2 years' experience in an office setting.
  • Proficient with Microsoft Office software.
  • Understanding of basic accounting and personnel management.
  • Experience with billing and insurance.
  • Knowledgeable with EHR Systems.

COMHAR, Inc. is an EEO employer and maintains a drug-free workplace. We do not discriminate in services or employment based on race, color, religion, ancestry, national origin, sex, sexual orientation, gender identity, age, disability, past or present receipt of disability-related services or supports, marital status, veteran status, or any other class of persons protected by federal, state, or local law.



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