PA (Prior Authorization) Unit Supervisor

$2,000 Sign-On Bonus for new employees!

The PA Unit supervisor directs the activities of the staff responsible for processing payment authorizations used by treatment providers for reimbursement of services. The PA Unit supervisor works in coordination with the SAI/BHI program staff and treatment providers in the overall management of the Payment Authorization (PA) process.

QUALIFICATIONS:

• Must possess strong communication skills and solid clerical and computer competency, including knowledge of the Microsoft Word and Microsoft Excel programs
• Must possess familiarity with the NJMMIS (or managed care company billing platforms) and SAI/BHI program data systems
• Should possess supervisory experience
• High school diploma or equivalent

RESPONSIBILITIES:

• Manages the day-to-day operations of the Unit, including developing a schedule for and assuring routine completion of key activities.
• Hires, supervises, and evaluates the staff.
• Serves as the PA Unit liaison to the State, SAI/BHI program staff, and treatment providers for payment and claims issues.
• Runs and reviews data reports to monitor accuracy and quality of PA Unit work.
• Creates the Payment Authorizations monthly for treatment providers, comparing the attendance units requested to the CSR/pre-authorizations.
• Monitors Medicaid ineligible PAs, works with SAI/BHI program staff on eligibility issues to ensure payment for treatment providers.
• Assists treatment providers with any claim/billing issues.
• Assists the SAI/BHI Program supervisors in training treatment providers regarding attendance and UDS submission and the processing of Medicaid claims.
• Maintenance of SAI/BHI system web portal accounts for treatment providers.
• Assists the clinical staff with data entry issues surrounding placements, clinical reviews and pre-authorizations.
• Manages the Intent to Close process, including running the reports and generating client and treatment provider letters.
• Maintenance of NJMMIS accounts including communication with the State regarding new user accounts/logins and the tracking of user accounts/logins with a suspended status.
• Maintains the PA Number range data in the Atlantis system.
• Assists PA Unit staff with entering attendance, uploading client release forms and other data entry tasks as needed in the SAI/BHI database.
• Serves as a back-up to the PA TANF e-Timesheet Specialist and enters attendance for TANF recipients into the State of New Jersey’s e-Timesheet application.
• Participates in special projects assigned by the Director of Care Coordination Services.

Excellent benefits, generous time off and 35-hour work week. No nights or weekends. EOE No phone calls and no staffing services, we are only able to respond to those candidates who meet our qualifications.

We are committed to diversity, equal opportunity, and fair treatment, and strive for an organizational structure and culture that promotes employee involvement, open communication, teamwork, and cooperation.

This position is based out of Robbinsville and can be a hybrid work from home role once fully trained.

Salary: $50,000.00 – $52,000.00 annually

Please send resume and cover letter to [email protected]