Prior Authorization Billing Specialist

About Team Recovery:Team Recovery is an addiction treatment center dedicated to supporting individuals affected by substance use and mental health disorders.

We offer a full continuum of care, including inpatient detox, residential treatment, outpatient services, and recovery housing, designed to meet people where they are in their recovery journey.

Our team is made up of professionals, many with lived experience, who understand the challenges of addiction and the power of connection.

With a mission to improve lives and a vision to redefine treatment, were committed to creating lasting change in the communities we serve.

Team Recovery is more than a treatment center.

We're a new approach to an old problem.

Job Summary: The Prior Authorization Specialist is responsible for managing the pre-authorization processes to ensure the timely submission of requests to insurance companies for healthcare services provided.

They will work closely with healthcare providers, insurance companies, and other stakeholders to ensure compliance with regulatory standards and maximize revenue collection in a timely and efficient manner.

Core Responsibilities: Obtain prior authorizations from insurance companies for behavioral health and addiction recovery services and medications.Review client medical records and treatment plans to determine the medical necessity of requested services.Submit prior authorization requests to insurance companies and follow up on the status of pending requests.Communicate with healthcare providers, insurance companies, and clients to gather necessary information for prior authorizations.Ensure compliance with insurance requirements and guidelines for prior authorizations.Maintain accurate records of prior authorization requests and approvals.Stay up to date on insurance policies and guidelines related to addiction recovery services.Collaborate with the clinical team and billing department to facilitate the prior authorization process.Process and submit insurance claims.Verify insurance coverage and benefits for clients seeking behavioral health and addiction recovery treatment.Review client accounts and ensure accurate billing and coding of services provided.Follow up on unpaid claims and denials, and resubmit claims as necessary.Communicate with insurance companies, clients, and healthcare providers to resolve billing issues.Stay up-to-date on insurance regulations and billing guidelines related to behavioral health and addiction recovery services.Maintain client confidentiality, adhere to 42 CFR, and HIPAA regulations.Collaborate with revenue cycle management, finance, and clinical staff to ensure accurate and timely billing practices.Provide excellent customer service to clients regarding billing inquiries and concerns.Attend required staff training and development meetings.Flexibility to adapt to schedule changes and assumption of responsibilities not delineated in the job description which are related to work as a member of an addi...