OMHC Prior Authorization Specialist

Baltimore, MD

The specific statements shown in each section of this job description are not intended to be all-inclusive. They represent typical elements and criteria necessary to perform the job successfully. Job responsibilities may be modified or expanded over time, and the company will inform the contractor of any such changes.

Enterprise Management Solutions, LLC (EMS) is a full-spectrum consulting and management firm specializing in back-office operations, financial infrastructure, and executive oversight for health and human services organizations. We provide strategic support to affiliated companies through contractual partnerships, optimizing operations and maintaining compliance across multiple industries including behavioral health, primary care, real estate, supportive housing, and food service.

Our goal is to relieve mission-driven companies of administrative burden by overseeing financial and operational systems that allow leadership teams to focus on quality care and innovation.

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POSITION TITLE:

OMHC Prior Authorization Specialist

ALTERNATE TITLE(S: PA Coordinator, Authorization & Intake Coordinator

COMPANY:
Enterprise Management Solutions, LLC

DIVISION:
Accounting & Finance

DEPARTMENT:
Accounts Receivables

UNIT:
Prior Authorization

ACCOUNTABLE TO:
Prior Authorization Unit Supervisor (Accounts Receivables Department Manager in the absence of the Prior Authorization Unit Supervisor)

ACCOUNTABLE FOR:
Timely and accurate submission of authorization requests and intake coordination for OMHC clients

CLASSIFICATION:
Exempt – Independent Contractor (Non-U.S., W-8

BEN)

WORK SCHEDULE:

This schedule reflects 8 hours per day, totaling 40 hours per week, Monday through Friday, 8:00 AM–5:00 PM. Scheduling needs may vary based on business demands, and adjustments may be required as reasonably assigned.

COMPENSATION RANGE: $4.50 - $6 USD per hour

ANTICIPATED TRAVEL: N/A

The OMHC Prior Authorization Specialist is responsible for coordinating the intake and authorization process for clients referred to Community Wellness Outpatient Mental Health Center and Freedom Healthcare Primary Care Freestanding General Clinic. This includes ensuring all medical necessity documentation is complete, submitting timely prior authorizations, tracking approvals, and maintaining records in compliance with payer requirements.

This role ensures that all clients are fully authorized for services at least three (3) business days prior to their scheduled start date, minimizing service disruptions and maximizing reimbursement potential.

• Collect and verify intake documentation for new clients referred to OMHC programs
• Review insurance requirements and authorization timelines for each payer
• Prepare, submit, and track initial and continuing authorizations in compliance with MCO or Medicaid requirements
• Monitor authorization expiration dates and initiate renewal requests proactively
• Communicate with providers and clinical staff to obtain missing information or signatures
• Update EHR systems and internal trackers with status of each authorization
• Ensure all intake and authorization tasks are completed within internal timelines, including 3-day minimum prior to service
• Notify clinical and scheduling departments of authorization approvals or delays
• Support intake calls and triage referral inquiries as needed
• Maintain organized electronic records for audit readiness and compliance

• Assist your supervisor with any work-related tasks as…