Remote Prior Authorization Specialist (OMHC)

Enterprise Mangement Solutions Inc; Baltimore (MD); Hybrid; USD 12,894,000 - 17,192,000; Full time

Job summary

Enterprise Management Solutions, LLC seeks an OMHC Prior Authorization Specialist to coordinate intake and authorization for OMHC and related clinics. You will ensure medical necessity docs are complete, submit authorizations on time, track approvals, and maintain payer-compliant records.

Must handle pre-start authorizations at least three business days prior to service, minimizing disruptions and protecting reimbursement potential. Remote work is available with standard 8–hour days.

Qualifications

• High school diploma or equivalent; Associate’s or Bachelor’s degree preferred.
• 1–2 years of healthcare administration, authorizations, or intake coordination.

Responsibilities

• Collect and verify intake documentation for new clients referred to OMHC programs.
• Review insurance requirements and authorization timelines for each payer.
• Prepare, submit, and track initial and continuing authorizations in compliance with payer requirements.
• Monitor authorization expiration dates and initiate renewal requests proactively.
• Communicate with providers and clinical staff to obtain missing information or signatures.
• Update EHR systems and internal trackers with status of each authorization.
• Ensure all intake and authorization tasks are completed within internal timelines, including 3-day minimum prior to service.
• Notify clinical and scheduling departments of authorization approvals or delays.

Skills

Medicaid knowledge

Medical terminology

EHR proficiency

Time management

Attention to detail

Communication skills

Education

High school diploma or equivalent; associate/bachelor preferred

Job description

Enterprise Management Solutions, LLC seeks an OMHC Prior Authorization Specialist to coordinate intake and authorization for OMHC and related clinics. You will ensure medical necessity docs are complete, submit authorizations on time, track approvals, and maintain payer-compliant records.

Must handle pre-start authorizations at least three business days prior to service, minimizing disruptions and protecting reimbursement potential. Remote work is available with standard 8–hour days.