Medicaid Authorization & Documentation Specialist

Medicaid Authorization & Documentation Specialist

Volunteers of AmericaGreater New York (VOAGreater New York) is a leading anti-poverty organization serving neighbors in need across New York City, Northern New Jersey, and Westchester. Through 70+ programs, we support over 35,000 adults and children each year, including individuals experiencing homelessness, survivors of domestic violence, youth aging out of foster care, veterans, seniors, and children with developmental delays.

Our staff are at the heart of this work, creating meaningful change every day. If you're passionate about making a difference and joining a mission-driven team, we invite you to explore this opportunity.

We are currently seeking qualified candidates for the following position:

Position: Medicaid Authorization & Documentation Specialist

The Medicaid Authorization 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).

Location: Rahway, NJ 07065

Minimum Qualifications:

• This position requires a Bachelor's Degree in Healthcare Administration, Social Work, Public Health, or related field.
• Minimum of 24 years of experience in Medicaid managed care, healthcare, or social services is preferred, including prior authorizations, documentation review.
• Experience in behavioral health or community-based programs is preferred.
• Experience working with electronic health record (EHR) systems and basic data tracking tools (e.g., Excel) is strongly preferred.
• A combination of education and relevant experience will also be considered.
• The ideal candidate will demonstrate strong attention to detail, organizational skills, and the ability to manage multiple priorities and deadlines. The candidate should also possess effective communication and problem-solving skills to collaborate with internal teams, funders, and external payers.
• Position requires a valid driver's license.

Medicaid Authorization & Documentation Specialist Principal Responsibilities:

1. Obtain, track, and manage Medicaid and MCO prior authorizations and re-authorizations. Coordinate 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.
2. 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.
3. Conduct concurrent and retrospective chart reviews of medical records and treatment plans to assess documentation quality and appropriateness for services billed.
4. 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.
5. Perform other related duties as assigned to support program operations, documentation compliance, billing readiness, and audit/monitoring requirements.

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
• Retirement Plan
• Tuition Reimbursement
• Paid Time Off, including a Paid Birthday Holiday

And much more!

Volunteers of America-Greater New York