Authorization Specialist

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  "source_hash": "4802e390a7689aee5d679a269214ed21a22019c2b31abddac3ba6d339ba8cf40",
  "last_changed_at": "2026-06-04T11:35:47.538Z",
  "active_status": "deleted"
}

{
  "language": "en",
  "location": {
    "raw": "Raleigh, North Carolina",
    "city": "Raleigh",
    "region": "NC",
    "country": "United States",
    "is_remote": true,
    "confidence": 0.85
  },
  "salary_max": null,
  "salary_min": null,
  "inferred_at": "2026-06-02T10:47:25.275Z",
  "launch_scope": {
    "reason": "english_us_canada",
    "included": true,
    "language": "en",
    "location": {
      "raw": "Raleigh, North Carolina",
      "city": "Raleigh",
      "region": "NC",
      "country": "United States",
      "is_remote": true,
      "confidence": 0.85
    },
    "countries": [
      "United States"
    ]
  },
  "remote_policy": "remote",
  "salary_period": null,
  "workplace_type": "remote",
  "salary_currency": null
}

{}

{
  "lists": [
    {
      "text": "Role Responsibilities ",
      "content": "<div><span style=\"text-decoration: underline;\"><strong>Clinician Partnership &amp; Insurance Support: </strong></span></div>\n\n<li>Serve as a resource to clinicians regarding payor-specific requirements, timelines, and documentation expectations.</li>\n<li>Provide structured guidance and tools to support accurate&nbsp;authorization submissions.</li>\n<li>Communicate upcoming authorization expirations,&nbsp;authorization requirements and help clinicians navigate the&nbsp;authorizations process.</li>\n<li>Assist clinicians in understanding authorization&nbsp;determinations, including denials, and appeal processes.</li>\n<li>Translate insurance requirements into clear, practical&nbsp;guidance for clinical teams.</li>\n\n<div><span style=\"text-decoration: underline;\"><strong>Authorization Submission &amp; &nbsp;Coordination</strong></span></div>\n\n<li>Coordinate submission of initial authorizations and reauthorizations through designated authorization platforms.</li>\n<li>Review submitted documentation for completeness and&nbsp;alignment with payor requirements prior to submission.</li>\n<li>Track authorization requests from submission through&nbsp;determination.</li>\n<li>Follow up with payors as needed to obtain updates or clarify&nbsp;requirements.</li>\n<li>Enter authorization details into practice management&nbsp;systems accurately and timely.</li>\n<li>Maintain organized and audit-ready records of authorization activity</li>\n\n<div><span style=\"text-decoration: underline;\"><strong>Re-Authorization Monitoring &amp; &nbsp;Revenue Support</strong></span></div>\n<div>\n\n<li>Monitor authorization expiration timelines and assist in&nbsp;coordinating timely re-submissions.</li>\n<li>Escalate potential risks related to authorization delays or&nbsp;lapses to the Manager, Revenue Cycle Operations or&nbsp;appropriate stakeholders.</li>\n<li>Collaborate with intake, scheduling, and billing teams to&nbsp;support alignment between authorizations and service&nbsp;delivery.</li>\n<li>Support efforts to minimize preventable authorization related service disruptions or billing challenges.</li>\n\n<div><span style=\"text-decoration: underline;\"><strong>Payor Navigation &amp; Appeals Support</strong></span></div>\n<div>\n\n<li>Maintain working knowledge of commercial and government&nbsp;payor policies and authorization processes.</li>\n<li>Assist with preparation and submission of appeals for partial&nbsp;or full denials under direction of leadership or clinical&nbsp;partners.</li>\n<li>Communicate professionally with payor representatives and&nbsp;utilization management teams.</li>\n<li>Support advocacy efforts aligned with clinical&nbsp;recommendations and organizational standards</li>\n\n<div><span style=\"text-decoration: underline;\"><strong>Process Support &amp; Cross-Functional &nbsp;Collaboration</strong></span></div>\n<div>\n\n<li>Identify recurring challenges within authorization workflows&nbsp;and communicate opportunities for improvement to&nbsp;leadership.</li>\n<li>Maintain internal documentation related to authorization&nbsp;processes and payor requirements.</li>\n<li>Participate in tracking and reporting activities related to&nbsp;authorization timeliness and outcomes.</li>\n\n</div>\n</div>\n</div>"
    },
    {
      "text": "Role Requirements: ",
      "content": "\n<li>High school diploma AND 2+ years experience supporting&nbsp;healthcare insurance&nbsp;authorizations, utilization&nbsp;management workflows,&nbsp;revenue cycle operations, or&nbsp;related roles such as intake&nbsp;coordination, utilization&nbsp;review support, medical&nbsp;billing/AR follow-up, or&nbsp;therapy service authorization&nbsp;coordination - OR</li>\n<li>Bachelor's degree in Healthcare&nbsp;Administration, Business, Behavioral Health, or&nbsp;related field AND 1+ years foundational experience in&nbsp;healthcare operations,&nbsp;insurance authorization&nbsp;processes, or payor interaction.</li>\n<li>Strong organizational skills&nbsp;with the ability to manage&nbsp;multiple deadlines and track&nbsp;complex workflow - required</li>\n<li>Effective written and verbal&nbsp;communication skills; ability to&nbsp;translate complex payor&nbsp;requirements into practical&nbsp;guidance - required.</li>\n<li>Experience coordinating&nbsp;healthcare authorization&nbsp;submissions or tracking&nbsp;authorization workflows - required.</li>\n<li>Experience working with&nbsp;commercial and/or&nbsp;government payors (Medicaid,&nbsp;Tricare, commercial insurers) - required.</li>\n<li>Proficiency in Microsoft Office&nbsp;Suite (Excel, Word, Outlook)&nbsp;- required.</li>\n<li>Experience using collaboration&nbsp;tools such as SharePoint,&nbsp;OneDrive, and Microsoft&nbsp;Teams - required.</li>\n<li>Experience supporting ABA&nbsp;services, behavioral health&nbsp;programs, or therapy-based&nbsp;authorization workflows - preferred.</li>\n<li>Experience interpreting payor&nbsp;policies or authorization&nbsp;criteria - preferred.</li>\n<li>Experience with practice&nbsp;management systems (e.g.,&nbsp;CentralReach) - preferred.</li>\n<li>Experience supporting&nbsp;authorization appeals or&nbsp;denial follow-up - preferred</li>\n"
    }
  ],
  "country": "US",
  "createdAt": 1779454880090,
  "updatedAt": null,
  "categories": {
    "team": "Operations",
    "location": "Raleigh, North Carolina",
    "commitment": "Full-Time",
    "department": "North Carolina",
    "allLocations": [
      "Raleigh, North Carolina"
    ]
  },
  "salaryRange": null,
  "workplaceType": "remote"
}