Reviews basic non-clinical initial authorization information, identifying and investigating any inaccuracies or inconsistencies found between the paper documentation and information entered into the Inpatient Authorization Program.
Forwards medical inconsistencies to Clinical Manager for review and correction.
Contacts appropriate in-patient treatment facilities departments to follow-up on needed paperwork.
Confirms medical eligibility and enters data into Provider One.
Maintains records on all initial authorizations, retrospective reviews and appeals, diversions, or other processes.
Logs all data into excel spreadsheet.
Brings non-clinical inconsistencies to the attention of Authorizer and Coordinator.
Calls hospital to verify information.
Email initial authorization certification and denial documentation to inpatient treatment facilities and KCMHP, meeting timeliness requirements.
Maintains a copy of the fax confirmation information as part of case record.
Assists in collecting and disseminating information related to grievances or other appeal processes.
Assists in coordinating retrospective reviews by receiving review requests and gathering and disseminating documentation as necessary.
Prepares any correspondence to inpatient treatment facilities or other entities as needed.
Gathers information for preparation of Initial Timeframe Report for submission to the County on a monthly and quarterly basis.
Responsible for logging discharges in to Provider One.

Degree in Social Sciences or related field preferred
2 years of general office and data entry experience
Experience and familiarity working with Microsoft Office suite, with intermediate Excel skills.

Billing Specialist

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