Authorization Assistant

Pathways to Life Inc.
Location: 2808 S. Croatan Highway Suite D Nags Head NC 27959
Schedule: Full-time MondayFriday 8:00 a.m.5:00 p.m.

Pathways to Life Inc. is seeking a highly organized and detail-oriented Authorization Assistant to join our Nags Head office and support the authorization process for behavioral health services.

Working under the supervision of the Authorization Specialist this position helps ensure that authorization and reauthorization requests are complete accurate properly tracked and submitted on time. The Authorization Assistant reviews clinical documentation maintains electronic records and tracking systems communicates with clinical staff regarding missing information and supports the organizations quality and compliance efforts.

This is an excellent opportunity for someone who is dependable comfortable working with detailed information and able to manage multiple deadlines in a fast-paced behavioral health environment.

• Receive and log authorization and reauthorization packages submitted by Licensed Professionals and Team Leads.
• Review documentation for completeness and accuracy including Comprehensive Clinical Assessments Person-Centered Plans Crisis Plans service orders intake documents and supporting forms.
• Confirm that required guardianship consent and signature documentation is complete and properly maintained.
• Verify that authorization packages meet applicable NC DHHS Managed Care Organization and Pathways to Life requirements.
• Communicate with Team Leads and Licensed Professionals regarding missing incomplete or incorrect documentation.
• Submit verified authorization packages to the Authorization Specialist for final review and submission through the appropriate MCO portal.
• Upload verified documents authorization receipts and audit tools into the electronic health record.
• Update authorization tracking spreadsheets and team census records.
• Maintain denial and request tracking logs and follow up with staff to ensure requested information is received on time.
• Track authorization approvals denials pending requests and reauthorization deadlines.
• Provide regular status updates to the Authorization Specialist Team Leads and Program Directors.
• Assist with internal audits documentation reviews CARF compliance quality-improvement activities and the Records Review Committee.
• Review MCO communications and bulletins and notify leadership of relevant authorization or documentation changes.
• Complete additional administrative and data-management duties as assigned.

• At least one year of administrative experience in a behavioral health medical healthcare or social-services setting is preferred.
• Previous experience with behavioral health authorizations insurance verification clinical documentation or medical records is strongly preferred.
• Familiarity with electronic health record systems particularly Pangea Health is a plus.
• General understanding of behavioral health documentation requirements and MCO authorization processes is preferred.
• Advanced proficiency with Google Workspace including Google Docs Sheets Slides Calendar and Gmail.
• Strong data-entry recordkeeping and computer skills.
• High school diploma or equivalent required.

The ideal candidate will be:

• Exceptionally organized and detail-oriented.
• Able to identify missing or inconsistent information.
• Comfortable managing multiple priorities and time-sensitive deadlines.
• Able to work independently while following established procedures.
• Professional and responsive when communicating with clinical staff and leadership.
• Able to exercise good judgment and maintain strict confidentiality.
• Familiar with HIPAA requirements and the handling of protected health information.
• Comfortable working with diverse populations and multidisciplinary teams.
• Accurate dependable and consistent with follow-up.

• Complete all required company training within 30 days of hire.
• Successfully complete and maintain required CPR and CPI certifications.
• Have no substantiated findings of abuse or neglect listed on the North Carolina Health Care Personnel Registry.
• Disclose criminal convictions as required. Hiring decisions will be made in accordance with agency policy and applicable state regulations.
• Be able to occasionally lift carry push or pull up to 25 pounds.
• Be able to drive a motor vehicle as required for assigned responsibilities.
• Maintain schedule flexibility when operational needs require occasional evening or weekend availability.

• Health dental and vision insurance
• Paid time off
• Paid holidays

• Retirement plan

Pathways to Life Inc. provides community-based behavioral health services designed to support individuals and families in achieving stability independence and meaningful recovery. Our team is committed to quality care timely access to services regulatory compliance and respectful collaboration with the members and communities we serve.

Pathways to Life Inc. is an equal opportunity employer. Employment decisions are made without regard to race color religion sex national origin age disability veteran status or any other status protected by applicable law.