Authorization Verification Specialist

ABOUT FREEDOM HEALTH SYSTEMS, INC:

Freedom Health Systems, Inc. is a mission-driven healthcare advisory and management consulting firm that partners with behavioral health and human services organizations to improve access, equity, and operational excellence. We specialize in guiding providers through program development, accreditation, compliance, and clinical best practices—empowering them to deliver high-quality, person-centered care to their communities.

While we do not provide direct healthcare services, Freedom Health Systems plays a vital role behind the scenes by strengthening organizational infrastructure, supporting service expansion, and helping our partners lead with innovation and integrity. Our expertise spans a wide range of operational services, including revenue cycle management, prior authorization, virtual front office support, medical billing and coding, human resources, and compliance consulting.

At Freedom Health Systems, we are deeply committed to breaking down barriers in the behavioral health space, with a particular focus on serving marginalized and underserved populations. Our team fosters a collaborative, forward-thinking work environment where every employee contributes to advancing impactful, community-based care.

DISCLOSURES:

The specific statements shown in each section of this job description are not intended to be all-inclusive. They represent typical elements and criteria considered necessary to perform the job successfully. The job’s responsibilities/tasks may be modified and/or expanded over time. Company will inform the personnel member when changes in the respective job description are made.

COMPANY WEBSITE: https://freedomhs.org 

COMPANY PHONE NUMBER:  667-239-9572

HUMAN RESOURCES DEPARTMENT PHONE NUMBER:  667-239-9572 EXT 10

HUMAN RESOURCES DEPARTMENT EMAIL ADDRESS:  info@freedomhs.org 

POSITION TITLE: Appointment Rules Verification Specialist

ALTERNATE TITLE(S): Scheduling Compliance Coordinator, Intake & Verification Analyst

COMPANY: Freedom Health Systems, Inc. (in support of all customer companies under contract)

DIVISION: Operations

DEPARTMENT: Scheduling

UNIT: n/a

BENEFITS PACKAGE: Ineligible.

WORK SCHEDULE: Monday – Friday, 8:00 AM EST – 5:00 PM EST

ACCOUNTABLE TO: Scheduling Department Supervisor (Chief Operations Officer in the absence of the Scheduling Department Supervisor)

ACCOUNTABLE FOR:  Verifying that all active clients have current, valid authorizations for required services in compliance with payer rules, program category types, internal policies, and state regulations; supporting the integrity of client records and the discharge process across programs.

CLASSIFICATION: W8BEN

COMPENSATION RANGE: PHP 283.63 per hour

ANTICIPATED TRAVEL: none

SUMMARY OF POSITION RESPONSIBILITIES:

The Authorization Verification Specialist is responsible for ensuring that all clients across programs have active managed care authorizations for applicable services. This role includes daily verification of authorizations, tracking of new intakes and discharges, and monitoring documentation across systems to prevent billing gaps and service interruptions. The specialist works closely with the Prior Authorization and Revenue Cycle departments to ensure compliance, minimize delays, and maintain up-to-date records for ongoing care delivery.

SCHEDULED DUTIES AND RESPONSIBILITIES:

• Maintain accurate records confirming that all active clients have managed care authorizations appropriate to their category type and service level
• Verify that authorizations are obtained 5–7 days prior to scheduled appointments
• Notify the Prior Authorization Department of expired authorizations requiring re-obtainment
• Monitor authorization status and provide timely updates to stakeholders across departments
• Track discharged clients and confirm that a discharge summary is completed in ICANotes and a discharge ticket is created in the ticketing system
• Remove discharged clients from clinical schedules once documentation is completed
• Perform daily authorization verification for the upcoming week, addressing backlog as needed
• Conduct weekly Medicaid authorization audits to ensure accuracy and compliance
• Send daily updates to the Prior Authorization Department identifying clients requiring updated authorizations
• Generate and distribute weekly and monthly reports summarizing clients lacking authorization
• Manage and monitor the discharge process for clients continuing as community participants
• Conduct outbound calls to Discharged Category A clients to confirm continued interest in services
• Delete future appointments for discharged clients once discharge documentation is finalized
• Monitor and track uninsured clients to ensure timely follow-up or status updates
• Manage the New Intake Client Log, ensuring accurate time stamps and up-to-date information

UNSCHEDULED DUTIES AND RESPONSIBILITIES:

• Assist supervisor with work-related tasks as requested, taking initiative when appropriate
• Ensure compliance with company policies and regulatory standards (e.g., COMAR, CARF, CSA)
• Support internal audits, quality assurance, and performance improvement initiatives
• Participate in safety drills, staff trainings, and compliance meetings as needed
• Maintain confidentiality of sensitive client information at all times
• Contribute to process improvements that enhance authorization turnaround and service coordination
• Cross-reference appointments with insurance authorizations, service caps, and referral requirements
• Resolve authorization-related scheduling discrepancies prior to the date of service
• Collaborate with scheduling, intake, and clinical teams to validate and correct appointment data
• Track authorization-related errors and contribute to trend analysis and QA reporting
• Ensure that all scheduled services meet payer compliance, including Medicaid, Medicare, and private payor rules
• Maintain and update real-time authorization dashboards, logs, and reports
• Support onboarding and training for new staff on authorization protocols and verification processes
  

PHYSICAL DEMANDS:

• Prolonged periods sitting at a desk and working on a computer
• Frequent meetings via video or phone; occasional in-person site visits

WORKING CONDITIONS:

• Remote
• Fast-paced, deadline-driven environment with collaborative teams
  

COMPETENCIES AND SKILLS:

• Strong understanding of healthcare authorization processes and payer requirements
• Familiarity with Medicaid, Medicare, and commercial insurance guidelines
• Excellent attention to detail, follow-through, and documentation accuracy
• Strong written and verbal communication skills
• Ability to manage time, prioritize tasks, and meet authorization deadlines
• Proficiency in EHR systems, Excel, and internal tracking databases
• Team player with a collaborative, problem-solving approach
  

LEVEL OF EDUCATION / TRAINING / QUALIFICATIONS:

• High school diploma or GED required; Associate’s or Bachelor’s degree preferred
• Minimum 1–2 years of experience in healthcare authorization, billing, or administrative support
• Experience in behavioral health or community-based outpatient programs strongly preferred
• Must pass a background check and reference screening
• Working knowledge of HIPAA, patient confidentiality, and healthcare documentation best practices