Medicaid Authorization & Documentation Specialist

Medicaid Authorization & Documentation Specialist Rahway, NJ 07065 Job Description Responsibilities 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. 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. Qualifications Bachelor’s Degree in Healthcare Administration, Social Work, Public Health, or related field. Minimum of 2–4 years of experience in Medicaid managed care, healthcare, or social services with prior authorizations and documentation review. Experience in behavioral health or community‑based programs preferred. Experience working with electronic health record (EHR) systems and basic data tracking tools (e.g., Excel) strongly preferred. Strong attention to detail, organizational skills, and ability to manage multiple priorities and deadlines. Effective communication and problem‑solving skills to collaborate with internal teams, funders, and external payers. Valid driver’s license required. Combination of education and relevant experience will also be considered. Benefits Prescription Coverage Life Insurance Retirement Plan Tuition Reimbursement Paid Time Off, including a Paid Birthday Holiday VOA‑Greater New York is an Equal Opportunity Employer/Vets/Disabled/Other Protected Categories. Apply today! #J-18808-Ljbffr Voa-Gny