About this role
The Prior Authorization and Medical Records Specialist is responsible for obtaining and managing insurance authorizations to support timely patient access to services within various Behavioral Health programs, including partial hospitalization (PHP), intensive outpatient program for addiction (IOP), neuropsychology, and psychiatric medication management practices. This role serves as a liaison between providers, patients, and insurance payers to ensure required authorizations are secured prior to treatment, testing, and medication services. The specialist reviews clinical documentation, submits authorization requests, tracks approval statuses, manages denials and appeals, and maintains accurate records within the electronic medical record. Success in this role requires strong organizational skills, attention to detail, knowledge of insurance requirements, and a commitment to supporting high-quality patient care through efficient and compliant authorization processes.