Authorization Associate (Org Wide) (Home Based)

Job description

Description Join our award winning culture as we serve members in your area! Under the general supervision of the Service Utilization Supervisor, this position manages service authorizations in the Lakeland Care electronic member record system. This position supports Interdisciplinary Teams (IDT) by ensuring authorizations are accurately completed based on IDT Resources Allocation Decision (RAD) determinations, maintaining compliance with policy and documentation requirements. As a subject matter expert, this position reviews service guidelines, verifies provider information, monitors quality and compliance, coordinates with claims as needed, and provides resources to IDT staff on best practices to ensure accurate authorizations, documentation, and claims processing. Essential Competencies: - Timely and accurately enter and modify service authorizations into the electronic member record system, thereby reducing risk for duplicate claims, missing claims, or incorrectly coded claims. Review service guidelines, coordinate with claims on payment accuracy, and ensure authorizations align with policy requirements. - Conduct routine authorization audits and remediate any findings to ensur...