Medicaid Authorization & Documentation Specialist

Principal Responsibilities

• Obtain, track, and manage Medicaid and MCO prior authorizations and re-authorizations.
• Cook up and support the preparation and submission of appeals for authorization denials.
• Serve as a point of contact with MCOs for authorization status, documentation requests, and issue resolution.
• Review service documentation to ensure completeness, accuracy, and alignment with payer and billing requirements.
• Work collaboratively with program staff to resolve missing, incomplete, or non-compliant documentation.
• Conduct concurrent and retrospective chart reviews of medical records and treatment plans to assess documentation quality and appropriateness for services billed.
• Collaborate with Quality Assurance and Finance/Billing teams to track, monitor, and report metrics, outcomes, and follow-up actions related to authorizations and documentation.
• Maintain logs and tracking tools to support operational oversight, reporting, and audit readiness.
• Perform other related duties as assigned to support program operations, documentation compliance, billing readiness, and audit/monitoring requirements.

Benefits

We are committed to offering our employees an exceptional comprehensive benefits package that supports their health, well-being, and personal growth. Full-time employees enjoy:

• Medical, Dental, & Vision Coverage
• Prescription Coverage
• Life Insurance
• Retail Plan
• Tuition Reimbursement
• Paid Time Off, including a Paid Birthday Holiday

To learn more about our staff, culture and much more, copy and paste our website link into a browser: https://www.voa-gny.org/our-staff-and-culture/

About the Role

The Medicaid Authorization & Documentation Specialist is responsible for supporting program operations by coordinating Medicaid prior authorizations and ensuring documentation is complete and aligned with billing requirements. This position will work closely with Program, Finance/Billing, and Quality Assurance teams to promote high-quality service delivery and timely reimbursement. This position plays a key role in ensuring services are authorized, documentation is accurate, and claims are submitted efficiently to Medicaid Managed Care Organizations (MCOs).