Medicaid Authorization Specialist with LME/MCO Expertise

Complete Well-Care Source LLC; Salisbury (NC); On-site; USD 25,000 - 28,000; Full time

Job summary

Complete Well-Care Source, LLC is seeking an Authorization Specialist in Salisbury, NC to obtain, monitor, and maintain service authorizations in compliance with NC Medicaid and LME/MCO requirements. This role supports timely service delivery and audit readiness while protecting patient confidentiality.

You will submit and track prior authorization requests, verify eligibility and units, keep accurate records, and coordinate with clinical, billing, and administrative staff.

Qualifications

• High school diploma or GED required.
• Prior experience with NC Medicaid, LME/MCOs, or behavioral health authorizations preferred.
• Strong attention to detail, organizational skills, and regulatory knowledge required.

Responsibilities

• Submit, track, and follow up on prior authorization requests with NC Medicaid and LME/MCOs.
• Verify eligibility, service limits, authorization periods, and units prior to service delivery.
• Maintain accurate authorization records and communicate status to clinical, billing, and administrative staff.
• Support audits, compliance monitoring, and identify/report discrepancies to leadership.

Skills

Attention to detail

Organizational skills

Regulatory knowledge

Education

High school diploma or GED

Job description

Complete Well-Care Source, LLC is seeking an Authorization Specialist in Salisbury, NC to obtain, monitor, and maintain service authorizations in compliance with NC Medicaid and LME/MCO requirements. This role supports timely service delivery and audit readiness while protecting patient confidentiality.

You will submit and track prior authorization requests, verify eligibility and units, keep accurate records, and coordinate with clinical, billing, and administrative staff.