Prior Authorization Specialist

1 day ago


Canton, Ohio, United States CommQuest Services Inc Full time
Job Title: 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.

This 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 ensure compliance with payor guidelines
  • Collaborate with clinical staff and clients to resolve authorization issues
  • Manage denial and data reporting
  • Perform other duties as assigned
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
Benefits:
  • Generous time off, including Mental Health days
  • 10 paid holidays annually
  • Retirement plan with company match
  • Medical, Dental, and Vision plans
  • CEU/Licensure reimbursements and additional workshops/trainings

CommQuest Services, Inc. is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating a workplace that is inclusive and respectful of all employees.



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