Medicaid Authorization & Documentation Specialist

Medicaid Authorization & Documentation Specialist

Rahway, NJ 07065

• 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.

• 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.

• 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!