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Prior Authorization Specialist

2 months ago

Canton, Ohio, United States CommQuest Services Inc Full time
Prior Authorization Specialist

CommQuest Services Inc is seeking a skilled Prior Authorization Specialist to join our team in the Canton/Massillon area.

About the Role

The Prior Authorization Specialist will be responsible for securing prior authorizations for behavioral health services, ensuring that all necessary approvals are obtained from insurance companies before services are provided.

The role involves collaborating with clinical staff, clients, and insurance providers to maintain compliance with payor guidelines, reduce denials, and ensure smooth reimbursement for services rendered.

Key Responsibilities
  • Obtain prior authorizations for behavioral health services
  • Verify insurance coverage and benefits
  • Maintain compliance with payor guidelines and regulations
  • Reduce denials and ensure smooth reimbursement
  • Collaborate with clinical staff, clients, and insurance providers
Requirements
  • Master's degree in Counseling, Social Work, Psychology, Marriage and Family Therapy, or a related field
  • Current and valid licensure as a Licensed Professional Clinical Counselor (LPCC), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), etc. in the state of Ohio
  • Minimum of 2 years of experience in counseling, medical billing, prior authorizations, or insurance verification in a healthcare or behavioral health setting
  • Experience working with electronic health records (EHR) and billing software
  • Valid driver's license and reliable transportation
What We Offer
  • Generous time off, including Mental Health days
  • 10 paid holidays annually
  • Retirement plan with company match
  • Medical, Dental, and Vision plans
  • CEU/Licensure reimbursement and more

We are an equal opportunity employer. All applicants will be considered for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.