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Hybrid Authorization Specialist Authorization Specialist

ACES (Comprehensive Educational Services) · United States Of America · Hybrid

About the job

Job DetailsRemote TypeFully RemoteDescriptionJob Title: Authorization SpecialistLocation: Fully-RemoteWork Schedule: This is a full-time position, requiring 40 hours per week, Monday through Friday.Pay Rate: $18-22 (dependent on experience)About ACESACES is a rapidly growing autism services company dedicated to enhancing the quality of life for individuals and families impacted with autism or other special needs. We provide comprehensive, professional services to maximize individuals' potential in the home, school and community, throughout their lifespan.ACES’ distinguished care is grounded in an industry-leading model of behavioral artistry which combines the best clinical practice of traditional Applied Behavioral Analysis (ABA) with humanistic elements that help our clients generalize their skills and gain independence. At 30+ locations, we are motivated to grow both so that we can serve more clients and close the significant supply gap that currently exists across the United States. We are committed to attracting and cultivating the very best team members who embody ACES’ values and culture and are passionate about our work. For more information, visitJob SummaryThe Authorization Specialist is a vital member of the Client Intake and Operations department, responsible for managing the re-authorization process for ABA services. This role ensures that all necessary authorizations are obtained and maintained, facilitating the provision of uninterrupted care for clients. The Authorization Specialist serves as a liaison between the company, insurance providers, and clients to verify benefits, secure approvals, and address any authorization-related issues.Essential Job Responsibilities

  • Authorization Management: Proactively secure and track authorizations for ABA services, ensuring all necessary approvals are obtained prior to the start of services and maintained throughout the client's care.
  • Insurance Verification: Verify clients’ insurance coverage for ABA services, including confirming benefit details, coverage limits, and prior authorization requirements.
  • Documentation Preparation: Prepare and submit authorization requests to insurance companies, ensuring all required documentation is accurate, complete, and submitted in a timely manner.
  • Communication with Insurers: Maintain regular communication with insurance providers to follow up on authorization requests, address any issues or discrepancies, and expedite the approval process.
  • Client and Clinical Team Liaison: Serve as a point of contact for both clients and clinical teams regarding authorization status, explaining coverage details and any potential issues or delays.
  • Authorization Renewals: Monitor upcoming authorization expiration dates and coordinate with clinical teams to submit renewal requests as needed, preventing lapses in service.
  • Database Management: Accurately enter and update authorization information in the company’s billing and client management systems, ensuring all records are current and accessible.
  • Denial Management: Handle authorization denials by reviewing reasons, coordinating with clinical teams for additional information if necessary, and appealing decisions to insurance companies as appropriate.
  • Reporting and Analysis: Generate regular reports on authorization status, denials, and approval timelines, providing insights to management to support operational efficiency.
  • Compliance and Documentation: Ensure all authorization processes comply with regulatory standards and payer requirements, maintaining meticulous records for auditing purposes.
  • Continuous Improvement: Identify and implement process improvements to streamline the authorization workflow, reduce turnaround times, and enhance service delivery.
Note: The responsibilities outlined above are illustrative and may be subject to change based on organizational needs.QualificationsRequired Qualifications:
  • Experience in Authorization Management: Previous experience in managing insurance authorizations, preferably within the healthcare or ABA field.
  • Insurance Knowledge: In-depth understanding of insurance processes, including prior authorizations, benefit verification, and claims management.
  • Strong Communication Skills: Excellent verbal and written communication skills, with the ability to effectively interact with insurance providers, clients, and internal teams.
  • Organizational Skills: Highly organized, with the ability to manage multiple authorizations simultaneously and prioritize tasks to meet deadlines.
  • Technical Proficiency: Proficient in using billing and client management software, with strong skills in MS Office Suite (particularly Excel) for reporting and data management.
  • Problem-Solving Abilities: Ability to troubleshoot and resolve authorization issues, including handling denials and appeals.
  • Attention to Detail: Keen attention to detail to ensure accuracy in documentation, submissions, and record-keeping.
  • Professionalism: Maintains a professional demeanor, with a focus on providing excellent service and ensuring compliance with all relevant regulations.
  • Team Collaboration: Ability to work collaboratively with clinical teams, billing staff, and other departments to ensure smooth authorization processes.
  • Experience: 1-2 years of experience in a similar role within a healthcare or ABA setting is preferred.
  • Bilingual (Preferred): Proficiency in Spanish or another language is a plus.
Benefits & PerksACES knows what it takes to deliver the highest level of care for our clients, and we believe our team deserves to experience that care as well. We offer a robust benefit package, including health, vision and dental benefits, paid vacation/sick time, retirement options, pet insurance, and more, including:
  • Competitive salary and benefits package.
  • Opportunities for professional growth and development.
  • A supportive and collaborative work environment.
  • The chance to make a meaningful impact in the lives of individuals with autism and related developmental disorders.
Additional InformationACES is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender, gender identity, sexual orientation, marital status, national origin, disability, age or covered veteran status. We embrace diversity and encourage you to apply!To find out more about how ACES uses employee data for business purposes, see ourIf you are having any issues with submitting your application, please reach out to us directly at