Top 23 Authorization specialist/unit Jobs in Columbus

Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
- Weekends as needed
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid time off
- 401(k) matching
Quick Apply
Process Automation Specialist (Contract)
Blue Star Partners LLC —Columbus, OH
- $30 - $35 an hour
- Weekends as needed
- Remote
- Computer science
- Microsoft Access
- Computer Science
Quick Apply
Network Deploy Technician , Global Network Delivery (GND)
Amazon Data Services, Inc. —Johnstown, OH
- $30.91 - $54.18 an hour
- Full-time
- Computer science
- Computer Science
- Mid-level
- AD&D insurance
- Health insurance
Clinical Services Specialist
Delaware County, OH —Delaware, OH
- $29.22 - $47.13 an hour
- Overtime
- Psychiatry
- Addiction Medicine
- 5 years
Specialist, Treasury - Cash Management
Nationwide —Columbus, OH
- 8 hour shift
- Hybrid work
- Background check
- 5 years
- Mid-level
- Paid holidays
- Disability insurance
6d
Accounting Operations Specialist
Burger King —Grove City, OH
- $45,000 - $55,000 a year
- Extended hours
- Background check
- 18 years or older
- Microsoft Outlook
- Disability insurance
- Health insurance
Quick Apply
Sr. Technical Solution Specialist – Integrated Power Systems
Vertiv —Westerville, OH
- 5 years
- System design
- Master's degree
Warehouse Specialist (Heavy Equipment / Large Forklift / Physical Logistics)
Rexroth —Grove City, OH
- $26 - $29 an hour
- Full-time
- Mid-level
- Forklift
- High school diploma or GED
- Health insurance
- Paid time off
Quick Apply
Senior Technical Solutions Specialist - Integrated Thermal Systems
Vertiv —Westerville, OH
- Construction site
- 5 years
- Data analysis skills
Faculty - Center for Innate Immunity and Inflammation, OSU Comprehensive Cancer Center (Open Rank/Track)
The Ohio State University —Columbus, OH
- Email
- Background check
- Medicine
- Pass drug screening
- Health insurance
- Dental insurance
Assistant Professor (9M)
The Ohio State University —Columbus, OH
- Email
- Background check
- Classroom
- Pass drug screening
Sr. Manager Global Master Data Management
Vertiv —Westerville, OH
- Full-time
- Office
- SQL
- US work authorization
Assistant Professor - Practice/Part Time, Endodontics
The Ohio State University —Columbus, OH
- $2,550 a month
- Part-time
- Background check
- Pass drug screening
- 3 years
- Health insurance
- Dental insurance
Director - Packaging Automation Group (PAG)
Shorr Packaging Corp. —Groveport, OH
- $180,000 - $220,000 a year
- Full-time
- Hybrid work
- 5 years
- Presentation skills
- Bachelor's degree
- Health insurance
- Dental insurance
North American Account Manager (Versatics)
Hexion Inc. —Columbus, OH
- 18 years or older
- Microsoft Excel
- Microsoft Outlook
Lecturer – Opera Production Director (Spring 2027)
The Ohio State University —Columbus, OH
- Part-time
- Background check
- Classroom
- Pass drug screening
- Health insurance
- Dental insurance
Poultry Veterinarian and Outreach Specialist
The Ohio State University —Columbus, OH
- Email
- Background check
- Spanish
- Pass drug screening
- Health insurance
- Dental insurance
Senior Software Engineer
Central Insurance Company —Dublin, OH
- Full-time
- Hybrid work
- Computer science
- Computer Science
- Master's degree
- Health insurance
Account Manager - Columbus, OH Market
Millcraft —Columbus, OH
- Full-time
- Inventory management
- Mid-level
- Office
- Health savings account
- Health insurance
Quick Apply
5d
Supply Chain Manager
Continental —Marysville, OH
- Online Application
- 7 years
- Customer service
- Data analysis skills
- Disability insurance
- Tuition reimbursement

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Utilization Management Specialist

ST VINCENT FAMILY SERVICES
Columbus, OH

Quick Apply

Job Details

Full-time

Benefits

Paid time off
401(k) matching

Qualifications

Associate's degree

Full Job Description

At St. Vincent Family Services, it's our job to help families build bright futures. Make it your job, too!

We offer competitive compensation based on education, experience, licensure, and internal equity, along with comprehensive benefits, 401(k) matching, and a generous PTO package.

These are just a few of the many reasons to join our team.

SUMMARY

The Utilization Management Specialist is responsible for coordinating and managing all prior authorization activities for clinical services across multiple Medicaid Managed Care Organizations (MCOs). This position serves as the primary liaison between St. Vincent Family Services and MCO payors to ensure authorization requests are submitted timely, approved services are tracked accurately, and service disruptions are prevented.

The Utilization Management Specialist monitors client eligibility, tracks authorized units by procedure code, manages authorization renewals, and communicates authorization approvals and denials to treatment teams. This role works closely with clinical staff, program leadership, billing, and MCO representatives to maximize reimbursement, ensure compliance with payer requirements, and support continuity of care for clients.

ESSENTIAL DUTIES & RESPONSIBILITIES

Maintains confidentiality and compliance with HIPAA, agency policies, and payer regulations.
Serves as the primary point of contact for all MCO prior authorization activities.
Monitors and reviews MCO portals to track authorization status, pending requests, approvals, denials, and requests for additional information.
Verifies and documents client eligibility and insurance coverage prior to authorization submission and throughout treatment episodes.
Runs authorization utilization reports and analyzes data to identify clients approaching authorization thresholds.
Maintains an authorization tracking system that includes:
- Authorization numbers
- Approved dates of service
- Procedure codes
- Authorized units
- Units utilized
- Remaining units
- Expiration dates
Monitors service utilization and proactively identify clients nearing authorized unit limits.
Requests completed clinical documentation and authorization forms from treatment providers when renewal thresholds are met.
Reviews authorization packets for completeness and accuracy prior to MCO submission.
Submits initial, concurrent, and reauthorization requests to Medicaid Managed Care Organizations within required timelines.
Coordinates responses to MCO requests for additional documentation or clinical information.
Communicates authorization approvals, denials, partial approvals, and service changes to treatment team members in a timely manner.
Collaborates with program directors, treatment providers, and billing staff to resolve authorization concerns and prevent service interruptions.
Maintains organized electronic records of all authorization submissions, determinations, and correspondence.
Tracks authorization denial patterns and communicates trends to leadership.
Assists with audits, quality assurance activities, and compliance reviews related to authorization management.
Develops and maintains productive working relationships with MCO representatives.
Participates in department meetings, training, and process improvement initiatives.
Performs other duties as assigned.

QUALIFICATIONS

Education and/or Experience:

Associate's Degree required; Bachelor's Degree preferred in Healthcare Administration, Business Administration, Social Work, Public Health, or related field.
Minimum of two years of experience in healthcare authorization management, utilization management, medical billing, behavioral health administration, or related healthcare setting preferred.

Knowledge, Skills & Abilities:

Strong understanding of behavioral health authorization processes and payer requirements.
Knowledge of Medicaid and Managed Care authorization procedures preferred.
Excellent organizational skills and attention to detail.
Strong analytical skills and ability to interpret utilization and authorization reports.
Ability to manage multiple deadlines and competing priorities.
Ability to communicate effectively with clinical, administrative, and payer representatives.
Ability to maintain accurate records and follow complex payer requirements.
Ability to work independently while functioning as part of a collaborative team.

Technical Skills

Proficiency in Microsoft Outlook, Excel, Word, and Teams.
Ability to learn and navigate multiple MCO portals.
Experience with electronic health records and data management systems.
Ability to generate, analyze, and maintain utilization tracking reports.

WORK ENVIRONMENT

Standard office environment with occasional evenings/weekends for events. Hybrid schedule available after 90-day probationary period.

Requires prolonged sitting and extensive computer use.
Requires manual dexterity sufficient to operate a computer, telephone, and other office equipment.
Requires normal range of hearing and vision to prepare reports and communicate effectively.
May occasionally lift and/or move items up to 15 pounds.

Quick Apply

Refine Your Search

authorization specialist/unit jobs in columbus

Utilization Management Specialist

Process Automation Specialist (Contract)

Network Deploy Technician , Global Network Delivery (GND)

Clinical Services Specialist

Specialist, Treasury - Cash Management

Accounting Operations Specialist

Sr. Technical Solution Specialist – Integrated Power Systems

Warehouse Specialist (Heavy Equipment / Large Forklift / Physical Logistics)

Senior Technical Solutions Specialist - Integrated Thermal Systems

Faculty - Center for Innate Immunity and Inflammation, OSU Comprehensive Cancer Center (Open Rank/Track)

Assistant Professor (9M)

Sr. Manager Global Master Data Management

Assistant Professor - Practice/Part Time, Endodontics

Director - Packaging Automation Group (PAG)

North American Account Manager (Versatics)

Lecturer – Opera Production Director (Spring 2027)

Poultry Veterinarian and Outreach Specialist

Senior Software Engineer

Account Manager - Columbus, OH Market

Supply Chain Manager

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