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Prior Authorization Specialist

Moore Center Services

Based in Manchester, New Hampshire, The Moore Center is a state and regional innovator with more than 50 years of experience in helping people become productive, fulfilled members of the community. Working closely with each individual, The Moore Center identifies unique needs and creates individualized programs to enhance that person’s quality of life and that of the community as a whole.

We are an award-winning leader recognized for providing high quality, cost-effective services with a personal, caring touch to individuals with developmental and intellectual disabilities and acquired brain injuries, as well as services to children and senior citizens and training for the human services workforce.

Compassion, commitment and community provide the foundation for all of The Moore Center’s initiatives and inspire our primary goal: Creating opportunities for a good life.

The Moore Center is one of New Hampshire’s largest human services organizations, providing services to over 2,000 individuals with intellectual and developmental disabilities and acquired brain disorders, as well as award-winning, innovative programs for children, adults and senior citizens.

We offer a wide range of employment opportunities, competitive wages, and a comprehensive, competitive benefits package with all full-time positions. We’re also committed to our employees’ professional growth. Our training and development programs enable employees to build careers while constantly improving the ways in which we serve our clients.
For more information visit www.moorecenter.org.


A major reward of working in the Human Services field is knowing your daily work makes a positive impact on someone’s life!

The Moore Center’s Family Support Services team is growing and we’re seeking a Prior Authorization Specialist to assist in Prior Authorization generation, tracking, report generation and problem resolution to ensure the agency receives the multi-million dollar Medicaid revenue in a timely manner. Will also assist with all tasks related to revenue generation, such as individual budget review, revenue/data analysis and staff collaboration. 

Requirements:

The ideal candidate will have:

  • Associate’s degree or equivalent in related field; Bachelor’s degree preferred
  • A minimum of 1 - 2 years of related experience
  • Working knowledge of Developmental Disability System desired
  • Proficiency in Microsoft Office Suite and database systems; strong knowledge of Excel
  • Knowledge of individualized client budgets, Medicaid system and billing preferred
Responsibilities:

Responsibilities include:

  • Assist Client Benefits Services Manager in development and submission of Prior Authorizations (PA), including but not limited to filing, copying, mailing, printing, scanning as needed within PA process
    • Assist with PA renewals: copy Prior Authorization and Waiver System (PAWs) application, staple original paws app and functional screen to service agreements, mail to Medicaid Management Information System PAs, open mail, remove documents, date stamp when received, put in alpha order by last name
    • Assist with PA funding changes: create PA file, obtain current functional screen and service agreement amendment, prepare Unit Change Request form, Service Proposal, Case Management Narrative, budget
    • File service agreements and service agreement approvals by month in which PA is to be renewed
    • Assist  with scanning of original documents to Manager’s e-mail
    • Assist with monthly Supports Intensity Scale (SIS) Evaluation PAs:  create PA file, obtain current functional screen, create SIS justification memo, prepare Unit Change Request form or create new PAWs application, as applicable
  • Review Medicaid Managed Information System (MMIS) monthly for approved PAs
  • Enter PA approvals into Harmony and PAWs
  • Track and follow-up/reminders/problem solving for:
    • Certifications for Personal Care Services (PCS), and Participant Directed and Managed Services (PDMS)
    • Terminated Medicaid
    • Documents requested but not received for PA applications
    • Renewal application paperwork
  • Assist with monthly Health Risk Screening Tool (HRST) billing report
  • Update Tracking Log
  • Learn Specialty Services Tracker (SST) and act as a back up to the Specialty Services Manager
How to Apply:

We offer a competitive salary plus a comprehensive benefits package including:

  • Medical and dental insurance
  • Life insurance
  • Short and long-term disability insurance
  • Flexible Spending Account
  • Paid time off
  • Tax deferred savings plan (agency match of up to 4% after one year)

 

For more information and to apply, please visit www.moorecenter.org/moorejobs

Job Location:

Manchester

Date Added: November 12, 2020

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