RRP Prior Authorization Specialist at Enterprise Management Solutions, Inc | chakrie

Requirements

Minimum of 1–2 years of experience in healthcare prior authorizations, utilization management, admissions, intake coordination, or insurance verification
Experience supporting Residential Recovery Programs (RRP), Substance Use Disorder (SUD) treatment, behavioral health, or residential treatment programs strongly preferred
Working knowledge of Maryland Medicaid and Managed Care Organization (MCO) authorization requirements preferred
Experience using Electronic Health Records (EHR), payer portals, and Microsoft Office applications preferred

High school diploma or equivalent required
Associate's or Bachelor's degree in Healthcare Administration, Business Administration, Health Information Management, or a related field preferred
Ability to successfully complete required background and reference checks
Knowledge of Maryland Medicaid, Managed Care Organizations (MCOs), and behavioral health authorization processes
Understanding of Residential Recovery Programs (RRP), Substance Use Disorder (SUD), behavioral health, and residential treatment terminology
Strong knowledge of prior authorization, utilization management, and medical necessity documentation
Excellent organizational and time management skills
Strong attention to detail and ability to manage multiple concurrent authorization requests
Excellent written and verbal communication skills
Strong analytical and problem-solving abilities
Proficiency with Electronic Health Records (EHR), payer portals, Microsoft Office, and related software
Ability to work independently while collaborating effectively with multidisciplinary teams
Commitment to confidentiality, regulatory compliance, and continuous quality improvement

Responsibilities

A clear overview of what is expected, written by the people who posted it, with every detail you need to decide.

Qualifications, experience and the skills that matter most, along with anything that would make you stand out.

Practical next steps, the documents to prepare and the dates to keep in mind before you apply or get in touch.

Contact details, links to the official source and the notes our team adds after checking each listing by hand.

Skills & expertise

Qualifications, experience and the skills that matter most, along with anything that would make you stand out.

Practical next steps, the documents to prepare and the dates to keep in mind before you apply or get in touch.

Contact details, links to the official source and the notes our team adds after checking each listing by hand.

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Salary & benefits

A clear overview of what is expected, written by the people who posted it, with every detail you need to decide.

Qualifications, experience and the skills that matter most, along with anything that would make you stand out.

Practical next steps, the documents to prepare and the dates to keep in mind before you apply or get in touch.

Contact details, links to the official source and the notes our team adds after checking each listing by hand.

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