What are the responsibilities and job description for the Medical Operations Specialist position at The Behavior Exchange, Inc.?
Job Summary
We are seeking a skilled Medical Operations Specialist to join our team at The Behavior Exchange, Inc. As a key member of our staff, you will play a crucial role in supporting our operations by following company policies and procedures.
This position requires an individual with excellent organizational skills, great communication skills, and the ability to multitask. You will be responsible for identifying, developing, and maintaining referral sources and potential clients, as well as ensuring smooth operation of the organization, its core values, and mission.
Main Responsibilities:
Foster partnership and collaboration with payor representatives
Manage medical records requests, ensuring timely processing and adherence to privacy and regulatory standards
Process Improvement: Assist in the development and implementation of best practices for authorization management in collaboration with the billing team
Utilize Key Performance Indicators (KPIs) to track authorization metrics and improve efficiency in the authorization process
Stay informed of payer-specific requirements for authorization, documentation, and medical necessity, ensuring all necessary documentation is submitted for approval
Communicate with families about the importance of adhering to recommended service intensity to ensure the best outcomes for their child's therapy
Collaborate with the billing department to resolve billing discrepancies and aging issues
Requirements:
Experience in medical/behavioral/mental health/therapy-related organizations
Commercial and Medicaid authorization experience
Excellent verbal and written communication skills
Strong administrative, organizational, and problem-solving skills
Developing standards, promoting process improvement, reporting skills
Proficient in Microsoft Office
About Us:
The Behavior Exchange, Inc. is a professional office environment that operates in a fast-paced setting. This role routinely uses standard office equipment and requires minimal travel during business hours.
What We Offer:
A full-time position with Monday through Friday hours
A competitive salary package
Ongoing training and development opportunities
