Managed Care Authorization Clerk

Cumberland River Behavioral Health, Inc. • Corbin, KY • 1d ago

Job Title: MANAGED CARE AUTHORIZATION CLERK

Qualifications Include: High School Diploma or GED; Computer and typing skills; Organization skills; Submitting to and passing successfully a criminal records check and a drug screening test.

Hours: Monday through Friday, 8:00 am until 4:30 pm. Different hours may be required with the job or may be adjusted by Supervisor.

This position reports to the Executive Director.

Summary of Job Duties: The Managed Care Authorization Clerk will coordinate all managed care prior authorization forms or requests to ensure they are submitted accurately and timely.

Essential Duties and Responsibilities:

Review all authorization forms or requests for accuracy.

Make corrections as necessary. This may involve calling the Therapist, Intake Receptionist, or other staff.

Submit the prior authorization forms or requests to the appropriate Managed Care Company.

Organize and file the prior authorization forms or requests for easy access and for tracking those that are or are not authorized.

Send the approvals back to the appropriate office via email or eFax.

Correct and/or trouble shoot all prior authorization forms or requests that are not approved. This may involve calling the Therapist, Intake Receptionist, or other staff.

Resubmit prior authorization forms or requests as necessary.

Entering data into the computer may be necessary.

Must maintain confidentiality of sensitive information.

Other duties may be assigned as needed.

Required Job Skills:

Oral and written communication skills.

Typewriting and Computer skills.

Good organizational skills.

Ability to exercise good judgment, tact, diplomacy and compassion.

Ability to complete job tasks in a timely fashion.

Ability to get along with diverse personalities and maintain effective working relationships

Physical Demands and Work Environment:

The physical demands required to successfully perform this job include being able to push, pull, bend, stoop, stand, walk and lift up to 20 pounds. Reasonable accommodation will be made to enable the individual with disabilities to perform these essential functions.

The employee will normally work indoors at the Corbin Regional Office but may on occasion be required to work outside or at another location if necessary. The noise level in the work environment is mild to moderate.

Hours of work are structured 7.5 or 8.0 hour blocks of time but may be subject to irregular and/or flexible hours based on needs or demands.

Participation in annual training regarding infection control and safety in the environment including hazardous waste and blood borne pathogens will be required.

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