Authorization Specialist

Job Description

Lighthouse Behavioral Health Solutions (LBHS) provides individual, outpatient, intensive outpatient, partial hospitalization, residential, psychiatric services, and medication assisted treatment for mental health and substance abuse treatment needs. We are a treatment facility that prides itself in a welcoming and compassionate approach to substance use and mental health treatment. We believe our clients can achieve recovery and be valued community members through positive engagement and meaningful participation in treatment.Our Goal:

Our comprehensive approach to addictions treatment provides a continuum of care that begins with asking for help and continues through to ongoing peer support. In addition to our state-of-the-art treatment facilities and peer support centers across Central Ohio, we work to remove barriers and promote access to care through our integrative approach and evidence-based clinical treatment.

Join our exciting and fast-growing company in which you will have an impact on improving people's lives! Lighthouse Behavioral Health Solutions (LBHS) is looking for quality candidates who are pursuing professional growth in a supportive environment and can thrive in a collaborative team-focused culture.

9 Paid Holidays

Paid Time Off

Sick Time Off

Paid continuing education opportunities

Including clinical supervision for advanced licensure

Paid parental leave

Medical/Dental/Vision

401(k)

Life Insurance

STAR/HRSA/Ohio student loan forgiveness programs (for applicable roles and locations)

Position: Authorization Specialist

Job Summary: The Authorization Specialist ensures review of clinical documentation in line with insurance requirements and best practices, remits the required records and forms to obtain authorizations, follow-ups on the authorization requests, and works as a liaison with the clinical team and insurance providers to advocate for best practices and outcomes. This position reports to the Vice President of Revenue Cycle.

Duties and Responsibilities:

Duties include, but are not limited to:

Evaluate clinical documentation to ensure alignment with payer requirements, regulatory standards, and best practices

Leverage clinical expertise to ensure documentation meets payer requirements while supporting patient-centered care

Remit the required records and forms to obtain authorizations, follow-up on authorization requests, document outcomes and support growth within the clinical team relative to insurance requirements

Serve as a key liaison between clinical providers, insurance representatives, and revenue cycle leadership to streamline authorization processes

Document and effectively communicate authorization outcomes to relevant stakeholders, providing actionable insights for improvement

Develop and implement SOPs and training programs related to insurance authorization procedures, fostering a culture of compliance and excellence

Monitor authorization turnaround times and denial rates, providing actionable insights to improve efficiency and patient outcomes

Create and refine procedures to streamline the authorizations process and increase access to care

Other duties as assigned

Required Qualifications:

Bachelor's or Master's degree in Social Work, Counseling, or related field

Active Chemical Dependency or Mental Health license

1–3 years of relevant experience; experience in insurance authorization, utilization review, or revenue cycle management preferred

Strong understanding of clinical documentation and payer requirements

Excellent communication and advocacy skills to liaise between clinical teams and insurance providers

Proficiency with EHR systems and insurance portals

Must pass BCI check, all Corporate Compliance checks, and employment drug screen

Schedule:

Monday – Friday 8:30am - 5:00pm

Lighthouse is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, age, color, religion, sex, national origin, sexual orientation, disability status, genetics, gender identity and/or expression, protected veteran status, or any other characteristic protected by federal, state, or local law.

LBHS adheres to Title VII of the Civil Rights Act as amended, Ohio Civil Rights Act, and all applicable rules and regulations. LBHS is an equal opportunity employer.

Full-time