Authorization Specialist

Quality Care Rehab & Autism Center

Clinton Township & Shelby Township, MI | In-Person | Full-Time

About the Role

The Authorization Specialist is responsible for managing the insurance authorization process for all active and incoming patients across physical therapy, occupational therapy, speech therapy, and ABA services. This role ensures that treatment authorizations are obtained, tracked, and maintained accurately so that patients can receive uninterrupted care and the organization remains in compliance with payer requirements. You will work closely with clinical and administrative teams to monitor authorization timelines, resolve insurance-related issues, and ensure that no patient falls through the gap between referral and authorized treatment.

This is a process-driven, detail-intensive role that requires a strong understanding of insurance workflows, the ability to manage a high volume of active cases simultaneously, and a consistent standard of accuracy in documentation and communication.

What You Will Do

• Obtain and track insurance authorizations for new and active patients across all service lines
• Verify patient insurance eligibility and confirm coverage details prior to the start of care
• Monitor authorization timelines and initiate renewals proactively to prevent lapses in coverage
• Communicate with insurance payers to obtain, clarify, or appeal authorization decisions
• Maintain accurate and current authorization records in the electronic health record system
• Coordinate with internal departments to ensure scheduling and treatment activity aligns with active authorizations
• Identify and resolve authorization discrepancies, denials, and coverage gaps in a timely manner
• Communicate authorization status to relevant internal teams to support scheduling and treatment planning
• Document all authorization activity, payer communications, and status changes accurately and on the same day they occur
• Stay current on payerspecific requirements, plan changes, and authorization procedures
• Escalate complex authorization issues or denials to the appropriate contact

Hard Skills

• Experience in insurance authorization, medical billing, or a related healthcare administrative role required
• Working knowledge of insurance verification and prior authorization processes required
• Familiarity with Medicaid, managed care, and private payer authorization requirements preferred
• Electronic health record experience preferred
• Proficiency in Microsoft Office and similar platforms
• Accurate and efficient data entry with strong attention to detail
• Ability to read and interpret explanation of benefits documents, authorization letters, and payer correspondence
• Familiarity with HIPAA regulations and their application in a healthcare office setting
• Clear and professional written communication across email, internal messaging,

and patient documentation

Soft Skills

• Persistent and thorough — authorization work requires following through on every case until a resolution is reached, without letting items fall through the cracks
• Detailoriented — authorization errors have direct consequences for patient care and organizational revenue
• Calm and professional under pressure — payer interactions and denial

management can be challenging and this role handles them without frustration affecting quality

• Organized — managing a large volume of active authorizations at various stages requires a structured and consistent approach
• Proactive — authorization timelines are monitored and renewals are initiated before lapses occur, not after
• Clear communicator — authorization status affects scheduling, treatment, and

billing decisions and must be communicated accurately and promptly to the right people

• Collaborative — works across departments and understands that authorization is a

critical link between patient access and ongoing care

Compensation & Benefits

• Competitive pay based on experience
• Health benefits
• Paid time off
• Supportive, teamoriented work environment in a growing pediatric rehab
• organization

Quality Care Rehab & Autism Center is an equal opportunity employer

About Quality Care Rehab & Autism Center

Quality Care Rehab & Autism Center (QCRP) is a clinician-owned private clinic operating in Macomb County. We provide a multidisciplinary approach, offering OT, PT, Speech, and ABA Therapy with many opportunities for collaboration.