RCM Specialist

Pay Range : $27.88 - 32.07 / hr

Schedule : Monday - Friday, 8am - 4 : 30pm

Hybrid Role : 3 days onsite

Location : Skokie, IL

The Authorization Coordinator works with Medicaid and managed care organizations to ensure payer requirements are met so Trilogy services are billable under both Fee-for-Service (FFS) and CCBHC models. This role manages eligibility checks, payer updates, program change reviews, and failed claims report resolution. The Authorization Specialist partners with clinical staff and revenue cycle teams to prevent denials and support timely reimbursement. Coordinator will also act as a liaison between Trilogy and insurance providers regarding the status and eligibility for coverage for all relevant claims.

Essential Responsibilities

• Primary liaison with the state and MCO's regarding authorization and eligibility review issues for the agency.
• Partner with clinicians to ensure documentation is timely and supports the services identified.
• Submit and obtain updates regarding authorizations for service.
• Review MCO trackers and other reporting; identify trends, issues, or barriers regarding obtaining authorizations and report to leadership
• Communicate to employees when a client's insurance has lapsed. Collaborate with new insurance to obtain authorization information.
• Validate eligibility and coverage for clients across all payer types.
• Process and document payer changes in EMR (CareLogic).
• Review and process clinician program change requests, verifying if authorization is required.
• Resolve items on the failed claims report; escalate issues and trends to leadership
• Review and process client sliding scale applications and track for renewal
• Perform other duties and projects as assigned.

Qualifications

Benefits Offered

Equal Opportunity Employer

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