Prior Authorization Specialist - CommQuest Services Inc

Prior Authorization Specialist

Real-world impact. Life-changing outcomes.

CommQuest seeks aFull Time Prior Authorization Specialist in the Canton/Massillon area. The Prior Authorization Specialist is responsible for securing prior authorizations for behavioral health services, ensuring that all necessary approvals are obtained from insurance companies before services are provided. The role involves collaborating with clinical staff, clients, and insurance providers to maintain compliance with payor guidelines, reduce denials, and ensure smooth reimbursement for services rendered.

In this role, you will:

• Grow professionally
• Build valuable relationships
• Work on a team providing exceptional care
• Make a real difference

What is CommQuest?

CommQuest Services is one of the largest non-profit mental health, addiction recovery, and social services organizations in Northeast Ohio, working with clients from more than 34 counties in 12 facilities through more than 20 programs. We help people make positive changes in their lives through in-patient, outpatient and school-based programs, along with supportive services - from basic needs to employment assistance.

Are you interested in CommQuest, but don't see a job you are interested in right now? Send us your story, resume and qualifications to HR@commquest.org.

What you gain:

• Great experience in the behavioral health and substance abuse field.
• Visibility into how our community supports those in need.
• Opportunities to share your expertise.
• Peace of mind knowing you are benefiting the clients we serve and the community at large.

What you'll do:

• Obtain prior authorizations.
• Insurance Verification.
• Compliance maintenance.
• Denial, Data, and Reporting management.
• All other duties as assigned

Schedule:

M-F 8:00 AM - 4:00 PM (some flexibility).

Minimum Qualifications:

• Master's degree in Counseling, Social Work, Psychology, Marriage and Family Therapy, or a related field required.
• Current and valid licensure as a [Licensed Professional Clinical Counselor (LPCC), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), etc.] in the state of Ohio required.
• Minimum of 2 years of experience in counseling, medical billing, prior authorizations, or insurance verification in a healthcare or behavioral health setting required.
• Experience working with electronic health records (EHR) and billing software.
• Valid driver's license and reliable transportation

Full-Time Benefits:

• Generous timeoff, including Mental Health days
• 10 paid holidays annually
• Retirement plan with company match
• Medical, Dental, and Vision plans
• CEU/Licensure reimbursement and more!

We are an equal opportunity employer. All applicants will be considered foremploymentwithout regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.