Mental Health Administrative Specialist

Job Summary:

We are seeking a highly organized and proactive Mental Health Administrative Specialist to join our team. This role will focus on utilization review and prior authorization for Intensive Outpatient (IOP) and Outpatient (OP) levels of care for SUD and MH, ensuring the completeness and accuracy of clinical documentation, and assisting with on-site client coordination and business office tasks. Additionally, the role involves providing QA support and documentation review, assisting with project management and various other projects as needed.

Key Responsibilities:

Key Responsibilities:
1. Utilization Review & Prior Authorization:
   • Conduct utilization reviews for IOP and OP levels of care to ensure appropriate and timely service delivery. IOP is provided for both mental health and substance use primary diagnosis.
   • Obtain prior authorizations from insurance companies for mental health services and treatments.
   • Collaborate with clinical staff and insurance providers to resolve authorization issues or concerns.
     
2. Clinical Documentation Review:
   • Review client clinical records for completeness, accuracy, and compliance with regulatory and insurance requirements.
   • Ensure clinical notes and treatment plans are up to date and meet all necessary standards for documentation.
   • Provide weekly reports to clinical director and administrators on clinical documentation completeness, timeliness, and quality.
     
3. Client Coordination:
   • Act as a liaison between clients, clinical teams, and the business office to facilitate care coordination.
   • Assist clients with administrative tasks such as scheduling appointments and explaining service options.
   • Provide support to clients during their treatment journey by helping them navigate clinical and logistical aspects of care.
     
4. Business Office Support:
   • Assist with billing and coding inquiries related to mental health services.
   • Manage and process necessary administrative tasks for the smooth operation of the facility.
   • Monitor and maintain accurate client files and ensure confidentiality is upheld.
     
5. Cross-Training & Collaboration:
   • Cross-train with the scheduling and admissions teams to provide backup support when needed.
   • Assist with client intake, verification of insurance coverage, and documentation as part of the admissions process.
   • Support scheduling team by coordinating client appointments, ensuring minimal disruptions to treatment schedules.
     
6. Exposure to Clinical Care:
   • Gain exposure to clinical care processes by interacting with mental health professionals.
   • Participate in relevant meetings or training sessions to improve understanding of treatment protocols and clinical best practices.
   • Stay informed about clinical processes, ensuring administrative duties align with treatment goals.
     
7. Administrative Support to Executive Team:
   • Provide administrative assistance to the executive team, ensuring smooth operations across various organizational functions.
   • Assist with project management, tracking progress, and supporting the execution of various projects as directed by the executive team.
   • Help prioritize tasks and deadlines to ensure that key projects are completed on time and within scope.
   • Coordinate meetings, prepare agendas, and take meeting notes for executive projects and initiatives.
     
   
   

Qualifications:

• Experience:
  • At least 1-2 years of administrative experience in a healthcare or mental health setting.
  • Prior experience with utilization review, prior authorization, and insurance processes (initial request, concurrent review, extension and discharges)
  • Familiarity with Nevada payers and prior authorization requirements - Nevada Medicaid specifically
  • Familiarity with IOP and OP levels of care - knowledge of ASAM levels of care, LOCUS, GAD -7, PHQ-9 and clinical justification for these levels of care.
  • Understanding of chart components such as initial evaluation, treatment plan, progress notes and other behavioral health components
    
• Extreme Attention to Detail: Ability to meticulously review clinical documentation, ensuring completeness and accuracy at all times.
• Strong Time Management Skills: Capable of managing multiple tasks, tracking deadlines, and ensuring tasks are completed on time, including managing timelines for others.
• Problem-Solving & Issue Resolution: Ability to identify challenges, think critically, and resolve problems effectively to ensure smooth operations.
• Strong Initiative: Proactive in identifying tasks and responsibilities, taking the initiative to address challenges, and contributing to the overall efficiency of the team.
• Education: Bachelor's degree in healthcare administration, business, or related field preferred. In progress ok.
  

Preferred Skills:

• Excellent communication skills, both written and verbal, with the ability to interact professionally with clients and healthcare providers.
• Strong organizational skills with the ability to manage multiple projects simultaneously.
• Proficient in Microsoft Office Suite (Word, Excel, Outlook) and electronic health record (EHR) systems.
• Experience with project management tools and supporting executive-level functions is a plus.