Who are we?

At 360 Behavioral Health, we take pride in our long-standing commitment to providing exceptional care for individuals impacted by autism and other developmental delays. With over three decades of expertise, we are one of the original and most established Applied Behavior Analysis (ABA)-based behavioral health services authorities.Today, 360 Behavioral Health is one of the top ABA, enhanced personal assistance and respite providers in the United States. The commitment, dedication, and approach to care that guided our founders when they opened their doors continues to guide all we do today. Our devotion to their philosophy landed us on the list for “The 5 Best ABA Therapy Providers for 2023”, and to us being labeled as a certified “Best Place To Work”!

What would this role do?

We are seeking a dedicated and detail-oriented Healthcare Authorization Manager to join our team. The ideal candidate will be responsible for overseeing the authorization process for ABA and Respite services, ensuring that all required approvals from insurance and regional center payers are obtained efficiently and accurately. This role is critical in facilitating smooth client care operations and ensuring compliance with payer requirements.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES INCLUDE BUT ARE NOT LIMITED TO:

• Submit and manage pre-authorization requested for behavioral health services, procedures, and treatments to insurance companies and regional centers.
• Provide detailed clinical and justifications to support authorization requests.
• Collaborate with operational clinics to gather necessary documentation and clinical information.
• Communicate effectively with insurance companies to follow up on pending requests, address queries, and provide additional information as needed.
• Manage denied authorization requests, including understanding reasons for denial and initiating appeals.
• Prepare and submit appeal documentation and negotiate with insurance companies and regional centers to obtain approvals.
• Maintain detailed records of all authorization requests, approvals, denials, and appeals
• Ensure compliance with federal, state, and local regulations, as well as insurance company and regional center policies and guidelines.
• Ensure all documentation is saved and effectively labeled electronically in the EHR / RCM system
• Ensure HIPAA compliance in all processes
• Communicate with patients regarding the status of their authorization requests
• Educate patients about the approval process, their benefits, and coverage
• Monitor the efficiency and effectiveness of the authorization process
• Generate and analyze reports on authorization outcomes, denial rates, and other key metrics
• Identify and implement process improvements to enhance process efficiency

• Complete all duties and/or special projects assigned by leaders and/or the business.
• Support with People Operations initiatives as assigned.
• Assist with Administrative Team duties as assigned. These may include, but are not limited to: Administrative Assistant, Scheduling Coordinator, Scheduling Assistant, Clinic Based Administrator, or Regional Scheduler.
• Ensure regulatory compliance with insurance protocols, HIPPA, and other federal, state, and local regulations.
• Participating in team meetings, trainings, and professional development opportunities.
• Providing support for any office needs, if necessary, to run the office more efficiently.
• Conducting staff meetings and professional development meetings as indicated.

Must Haves

• Bachelor’s degree in healthcare administration, Nursing, or a related field preferred
• Minimum of 3 years of experience in healthcare authorization, medical billing, or a related role
• In-depth knowledge of insurance authorization processes, policies, and regulations
• Strong organizational and multitasking skills with attention to detail
• Excellent communication and interpersonal skills
• Proficiency in healthcare management software and electronic health records (EHR) systems
• Ability to work effectively in a fast-paced environment and handle high volumes of requests

What we offer

• Competitive compensation (we value transparency) $85,000-$95,000/ Salary
• Hybrid, minimum 1 day per week in office. Monday-Friday 8:00am-5:00pm
• Student loan repayment assistance for eligible roles
• Bonus program(s) for eligible roles
• Career development and advancement opportunities 
• Flexible scheduling 
• Great and fun company culture
• Expansive Health, Vision, and Dental plans for our full-time partners
• 401(K) retirement savings program
• Mileage and phone reimbursement 
• And so much more!

 360 Behavioral Health is an equal opportunity employer. If anyone is unable to fully access any portion of the 360 Behavioral Health on-line system, we are committed to providing reasonable accommodations. Please contact us at 855-360-4437 for assistance. 

EEO/Minorities/Females/Disabled/Veterans

Our organization is an equal employment/affirmative action employer. If you need accommodation for any part of the employment process because of a medical condition or disability, please send an e-mail to benefits360hr@360bhmail.com to let us know the nature of your request. For more EEO information about applicant rights click here. 

 Americans With Disabilities Act  

360 Behavioral Health, does not discriminate on the basis of disability in its services, programs, or activities. Employment: 360 Behavioral Health does not discriminate based on disability in its hiring or employment practices and complies with the ADA title I employment regulations. Effective Communication: 360 Behavioral Health will, upon request, provide auxiliary aids and services leading to effective communication for people with disabilities, including qualified sign language interpreters, assistive listening devices, documents in Braille, and other ways of making communications accessible to people who have speech, hearing, or vision impairments. Modifications to Policies and Procedures: 360 Behavioral Health, will make reasonable modifications to policies and procedures to ensure that people with disabilities have an equal opportunity to enjoy programs, services, and activities. For example, people with service animals are welcomed in 360 Behavioral Health offices, even where pets and other animals are prohibited. Requests: To request an auxiliary aid or service for effective communication, or a modification of policies or procedures contact [ADA Coordinator name and contact information] as soon as possible, preferably 30 days before the activity or event. For inquiries, please contact us at benefits360hr@360bhmail.com