Job type: Full-time

Description

***Effective October 15, 2021, all employees/contractors/interns/volunteers are required to provide our office with proof of COVID vaccination.***

Service Authorization Technician Job Summary:

Monday-Friday: 8:00AM-4:30PM with One (1) Day WFH

Service Authorization Technician Salary:

$37,440.00 ($18.00/HR)

COMHAR's Intensive Behavioral Health Services (IBHS) is located in the Philadelphia are. IBHS support children, youth, and young adults with mental, emotional, and behavioral health needs. Services are provide to children, youth, and young adults across all settings (at the home, school, and community settings) in order to both help them reduce and/or replace problem behaviors with more positive, socially appropriate behaviors, with the highest priority placed on family engagement throughout the process.

Service Authorization Technician Job Summary:

The Service Authorization Tech reports to the Office Manager of Children’s Services. The Service Authorization Tech will be responsible for admitting clients by gathering and recording provider, client, and insurance information. The Service Authorization Tech oversee preauthorization and referrals process for the IBHS program. Reporting to the Office Manager, this position’s primary responsibility is ensuring that billing authorizations are uploaded from CBH and correctly inputted into EVOLV.

Duties and Responsibilities

• Improve the proficiency of receiving and correcting authorizations for services.
• Other duties reasonable and related to this position as directed by related supervisors.

Admissions/Prior Authorization Specialist Job Duties: 

• Process client admissions.
• Track Discharges and submits to CBH to end any active authorizations.
• Pre-admits clients by receiving referrals from a number of sources, entering client information into the referral module in Evolv.
• Run initial eligibility through Promise for client.
• Secures payments by screening insurance information; identifying clients requiring pre-admission approvals from third-party payers; verifying approvals.
• Uploading and Downloading CBH authorizations.
• Developing and monitoring authorization reports that are reviewed with Office Manager. Monitors the authorization process of both individual and aggregate cases.
• Tracking and correcting authorizations for proper length and number of units. Meet weekly with CBH Care Manager to discuss authorization correction list.
• Documenting to ensure that the service hours & units match what was requested.
• Process contractor and temp agencies invoices.
• Ensures a responsive system for authorization of services and payment of claims by monitoring the COMHAR billing system for laps in service as well as rejections and error logs.

Major Duties/Essential functions: 

• Downloading and uploading of CBH authorizations.
• Processing of referrals.
• Processing invoices.
• Ensuring client eligibility.
• E-mail assigned staff and case managers about their clients ‘evaluation appointments.

Periodic Duties:

• Responsible for identifying alternative sites needed for expansion of services.
• Identifying possible requests for proposal and discuss these RFPs with Division Director of Children Services.
• Responsible for coordination of medical records storage.
• Will oversee the departments’ training needs, including tracking and monitoring.

Skill Requirements

• Excellent mathematical skills.
• Excellent verbal and written communication skills.
• Excellent interpersonal and customer service skills
• Proficient in Microsoft Office Suite or related software.
• Type 45–55 wpm
• Excellent organizational skills and attention to detail.
• Ability to read and write in both English and Spanish.
• Basic understanding of clerical procedures and systems such as recordkeeping and filing
• Ability to work independently.
• Ability to apply common sense and understanding to carry out instructions furnished in written, oral, or diagram dorm.
• Ability to deal with problems involving several concreate variables in standardized situations.
• Project a positive, accommodating demeanor and a customer satisfaction-focused mindset.
• Demonstrate the capability and willingness to learn and implement new and ongoing processes.
• Exercises sound judgment in carrying out daily activities and managing any issues which arise.
• Able to competently utilize Microsoft Office Suite, email, EHR, and technology used in the course of job duties.
• Strong commitment to providing quality services to members.

Service Authorization Technician Requirement:

• 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

We are proud to be an EEO employer M/F/D/V. We maintain a drug-free workplace. COMHAR, Inc. is a not-for-profit community based health and human service organization founded in 1975. We do not discriminate in services or employment on the basis of 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.