Administrative Authorizations & Insurance Specialist

Job description

**About the Role** Arundel Lodge is seeking an organized, detail-oriented **Administrative Authorizations & Insurance Specialist** to support our Outpatient Mental Health Clinic (OMHC). This role is essential in ensuring that clients receive uninterrupted behavioral health services by managing insurance verification, authorization processing, and billing support. The ideal candidate is experienced in behavioral health or medical office administration, excels in communication, and is committed to upholding the values of the Recovery Model when interacting with clients and staff. ### Position Summary - Employees are expected to utilize the principles of the **Recovery Model** in all interactions with persons served. This includes demonstrating hope, personal responsibility, empowerment, empathy, respect, peer support, and the use of non-stigmatizing language. Arundel Lodge provides ongoing training, and performance is evaluated on the application of these values in daily tasks and interactions. ### Primary Responsibilities - Verify client insurance eligibility, benefits, and behavioral health coverage prior to service delivery. - Prepare, submit, and monitor authorization requests for outpatient mental health services through payer portals. - Maintain accurate documentation of authorization approvals, denials, and expiration dates in the EHR. - Communicate authorization updates to clinical, administrative, and billing teams to ensure seamless service delivery. - Reconcile authorizations with scheduled and completed services to ensure compliance and billing accuracy. - Collect co-payments and outstanding patient balances following agency payment policies. - Assist the billing department with claim resolution, identifying discrepancies, and responding to payer inquiries. - Stay current on payer requirements, authorization processes, and benefit structures across all major insurance providers. - Provide timely, professional responses to client and staff inquiries related to insurance coverage, authorizations, and account balances. - Perform other duties or special projects as assigned by the Practice Manager or agency leadership. ### Work Expectations - Adhere to all Arundel Lodge, Inc. policies and procedures. - Work independently with minimal supervision while managing multiple priorities. - Maintain proficiency in computer applications, EHR systems, and insurance portal navigation. - Communicate clearly and professionally in both verbal and written formats. - Collaborate effectively with clinical, administrative, and billing teams. - Demonstrate cultural sensitivity and maintain respectful communication with diverse populations. - Maintain all required agency clearances (drug screening, TB test, background check, driving record if applicable). - Provide front desk registration and appointment scheduling support as needed across multiple locations. ### Experience - Minimum **1 year of experience** in a behavioral health or medical office setting performing: - Insurance verification - Authorization processing - Patient billing - Proficiency with **electronic health record systems** (Credible preferred) - Experience using **payer web portals** strongly desired ### Education & Experience Requirements - **Education** - High school diploma or equivalent required - Post-secondary coursework or certification in healthcare administration, billing, or insurance processing preferred