Prior Authorization Specialist

Medicaid Housing Agency is seeking a detail-oriented Prior Authorization Specialist to prepare and track service authorizations for adults in our NJ Supports Program. You’ll submit Initial Assessments (IATs), monitor renewals, and coordinate with our internal billing team — no direct client contact or PHI handling. We are seeking a Prior Authorization Specialist to support our team with preparing, submitting, and tracking Medicaid) housing service authorizations through the five managed care organizations (Aetna, Horizon, Fidelis, UnitedHealthcare, and Wellpoint). Position Overview You will manage the administrative process of prior authorization and reauthorization for Housing Supports Services. Your work ensures that all required forms and documentation are accurate, complete, and submitted on time for approval — keeping our members active and our billing compliant. You will not interact directly with clients or handle sensitive PHI. Instead, you’ll coordinate internally with our Housing Services Manager and Billing Team to maintain smooth authorization workflows. Key Responsibilities Prepare and submit Initial Assessment Tools (IAT) for prior authorization of services. Track approval and expiration dates for all member authorizations. Support Level of Need Assessments and Housing Stabilization Plans (continuation authorizations). Verify Medicaid enrollment and MCO assignment for each member. Maintain a digital log of all authorization numbers, effective dates, and MCO status. Communicate with MCO provider teams (via email or fax) to confirm receipt and status updates. Coordinate with the Billing Specialist to align authorizations with monthly claim submissions. Update spreadsheets and reports for management review. Ideal Candidate Qualifications Experience with U.S. healthcare or Medicaid prior authorization workflows (required). Familiarity with NJ Medicaid, MCO processes, or similar managed care systems (preferred). Strong attention to detail, time management, and organizational skills. Excellent English communication (email and documentation accuracy are key). Comfortable working in shared drives, Google Sheets, and secure databases. Available for at least 4-hour overlap with U.S. Eastern Time (EST). Technical Tools You’ll Use Google Workspace (Drive, Sheets, Gmail) Shared authorization tracker (Excel/Google Sheet) E-fax or MCO submission portals (training provided) Internal secure workflow system (no PHI exposure) Apply tot his job Apply To this Job