Medicaid Service Authorization Coordinator

The-Information-Center,-Inc.; Taylor (MI); Presencial; USD 48.000 - 72.000; Jornada completa

Descripción de la vacante

The-Information-Center,-Inc. is seeking a Service Authorization Coordinator to support timely coordination and accurate processing of Medicaid-funded services in Michigan.

You will manage authorization records, coordinate billing, review documentation, and work with vendors to resolve discrepancies, ensuring EVV compliance and regulatory adherence. Responsibilities include reviewing POS requests in Compass, maintaining authorization processes for MI Choice and Self-Determination, and monitoring

Formación

• Proficiency with Microsoft Office Suite, including Excel, Word, Outlook, and SharePoint.
• Strong analytical, organizational, time management, and problem-solving skills, with the ability to interpret data, identify trends, manage multiple priorities, and meet deadlines
• Effective written and verbal communication skills, including the ability to present findings, prepare reports, and communicate recommendations to leadership.
• Strong data entry and data management skills, with the ability to maintain accurate records and use electronic tracking and reporting tools.
• Knowledge of Medicaid waiver programs, MI Choice, Self-Determination, Home and Community-Based Services (HCBS), and related service authorization and documentation requirements preferred.
• Knowledge of Electronic Visit Verification (EVV), HIPAA, HCBS requirements, and applicable federal and state compliance standards.

Responsabilidades

• Coordinate the review, processing, and tracking of Purchase of Service (POS) requests within Compass for MI Choice Waiver and Community Transition Services.
• Coordinate and maintain service authorization processes for Self-Determination services, ensuring authorizations are accurate, timely, and aligned with program requirements.
• Maintain accurate authorization records and tracking tools to support timely processing, service delivery, and reporting.
• Process billing for Community Transition Services in accordance with established program requirements and departmental procedures.
• Serve as a point of contact for contracted vendors regarding service authorizations, billing, Electronic Visit Verification (EVV), documentation, and compliance requirements.
• Cross-reference vendor notices and POS requests with vendor invoices to verify that billed services are authorized, appropriate, and accurately documented.
• Communicate identified discrepancies to vendors and internal staff and support timely resolution of authorization, billing, and documentation issues.
• Monitor Electronic Visit Verification (EVV) processes for contracted vendors and services subject to EVV requirements, identifying, tracking, and reporting discrepancies and trends to management.
• Review vendor adherence to EVV documentation standards, including the timely and accurate recording of service delivery, visit validation, and billing documentation.
• Assist with EVV audits, reporting, and compliance activities, including the timely submission of required information and follow-up on identified discrepancies.
• Complete annual on-site Home and Community-Based Services (HCBS) residential setting surveys, as assigned, to assess contracted housing vendors' adherence to applicable HCBS requirements.
• Analyze authorization, billing, EVV, vendor, and documentation data to identify recurring issues, discrepancies, and trends.

Conocimientos

Compass system

Data analysis

Time management

Attention to detail

Verbal communication

Written communication

Excel

Word

Outlook

SharePoint

Educación

Bachelor's in Business

Bachelor's in Healthcare Administration

Bachelor's in Public Administration

Health Information Management

Herramientas

Compass system

Descripción del empleo

The-Information-Center,-Inc. is seeking a Service Authorization Coordinator to support timely coordination and accurate processing of Medicaid-funded services in Michigan.

You will manage authorization records, coordinate billing, review documentation, and work with vendors to resolve discrepancies, ensuring EVV compliance and regulatory adherence. Responsibilities include reviewing POS requests in Compass, maintaining authorization processes for MI Choice and Self-Determination, and monitoring