Service Authorization Specilaist

Service Authorization Specialist

Community Choices Inc. - Charlotte, NC

Department: North Carolina Programs

FLSA: Exempt/Fulltime

Location: In-person (Non-remote)

Salary: $44K annually

Schedule: Monday–Friday | Generally 8:00 AM–5:00 PM

Some schedule flexibility and occasional travel to program locations may be required based on organizational and consumer needs.

Help Keep Recovery Services Moving Forward

Community Alternatives, Inc. DBA Community Choices Inc. is seeking a highly organized and detail-oriented Service Authorization Specialist to support our North Carolina programs serving individuals receiving behavioral health and substance use treatment services.

This position plays a critical role in ensuring services are properly authorized, supported by medical necessity documentation, monitored for continued authorization, and accurately reported for billing. The Specialist works closely with clinical teams, program leadership, finance, and payer representatives throughout the authorization process.

What You’ll Do

• Request, obtain, and maintain service authorizations from Medicaid, managed care organizations, private insurance, and other payer sources.
• Track authorization dates, approved units, expiration dates, and reauthorization deadlines.
• Review clinical documentation to ensure medical necessity supports requested and continued services.
• Monitor authorizations from admission through discharge to help prevent interruptions in services.
• Communicate with payers regarding authorizations, denials, appeals, and service requirements.
• Review authorization and billing denials and coordinate corrections with program and finance teams.
• Maintain accurate authorization and service-delivery data using Excel and other electronic systems.
• Participate in admissions, case reviews, and multidisciplinary team meetings.
• Stay current on changes to authorization procedures, billing codes, payer requirements, and applicable regulations.

The position requires accuracy, independent judgment, strong communication, and collaboration with program staff and payer representatives.

Targeted Experience

We are especially interested in candidates with hands-on experience in:

• Medical/Behavioral Health Authorizations – Managing authorization requirements for healthcare, behavioral health, or substance use services.
• Authorization Requests – Preparing, submitting, and following up on initial authorization and reauthorization requests.
• Authorization Monitoring – Tracking approved units, authorization periods, expiration dates, and continued-stay requirements.
• Medicaid – Working knowledge of Medicaid requirements, processes, documentation standards, and payer guidelines.
• Medical Necessity – Reviewing clinical documentation to ensure services meet payer requirements for authorization.
• Payer Communication – Working directly with Medicaid, managed care organizations, and/or private insurance representatives regarding authorizations, denials, and appeals.

What We’re Looking For

• Bachelor’s degree in Human Services or a related/applicable field required.
• 3 years of utilization management experience preferred.
• 2+ years of experience working with Medicaid and/or private insurance.
• Intermediate proficiency with Microsoft Office Suite, particularly Excel.
• Strong organizational, analytical, communication, and problem-solving skills.
• Ability to manage multiple deadlines and maintain a high level of accuracy.
• Ability to work independently and collaborate effectively with multidisciplinary teams.
• Knowledge of HIPAA, Medicaid, managed care, and behavioral health regulatory requirements preferred.

Benefits:

• 403(b)
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Application Question(s):

• Are you available willing to work in-person for this position?
• Are you willing to work the schedule for this position?
• Please include your email address and phone number

Education:

• Bachelor's (Required)

Experience:

• Utilization management: 3 years (Required)
• Medicaid and/or private insurance.: 2 years (Required)
• Microsoft Office Suite, particularly Excel.: 3 years (Preferred)
• HIPAA and Managed care: 2 years (Preferred)
• Behavioral health regulatory requirements: 2 years (Preferred)
• Medical/Behavioral Health Authorizations: 2 years (Preferred)
• Authorization Requests: 2 years (Preferred)
• Authorization Monitoring: 2 years (Preferred)
• Medical Necessity: 2 years (Preferred)
• Payer Communication: 2 years (Preferred)

We are a V3 Sponsored Employer. We are an equal opportunity employer and value diversity in our workforce. We encourage applications from all qualified individuals regardless of race, ethnicity, gender, sexual orientation, age, disability, or veteran status.

Virginia Salary History Notice
Community Alternatives, Inc. complies with the Virginia Salary History Ban. Applicants are not required to provide current or prior wage, salary, bonus, commission, or other compensation information as part of the employment application or hiring process. If an applicant voluntarily discloses salary information, it will only be considered for the limited purpose of negotiating a higher wage or salary, as permitted by Virginia law.