RCM Specialist

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Location: Skokie, IL

Pay Range: $27.88 - $32.07/hr

Schedule: Monday - Friday, 8am - 4:30pm

Hybrid Role: 3 days onsite

The Authorization Coordinator works with Medicaid and managed care organizations to ensure payer requirements are met so Trilogy services are billable under both Fee-for-Service (FFS) and CCBHC models. This role manages eligibility checks, payer updates, program change reviews, and failed claims report resolution. The Authorization Specialist partners with clinical staff and revenue cycle teams to prevent denials and support timely reimbursement.

Coordinator will also act as a liaison between Trilogy and insurance providers regarding the status and eligibility for coverage for all relevant claims.

• Primary liaison with the state and MCOs regarding authorization and eligibility review issues for the agency.
• Partner with clinicians to ensure documentation is timely and supports the services identified.
• Submit and obtain updates regarding authorizations for service.
• Review MCO trackers and other reporting; identify trends, issues, or barriers regarding obtaining authorizations and report to leadership.
• Communicate to employees when a client’s insurance has lapsed. Collaborate with new insurance to obtain authorization information.
• Validate eligibility and coverage for clients across all payer types.
• Process and document payer changes in EMR (Care Logic).
• Review and process clinician program change requests, verifying if authorization is required.
• Resolve items on the failed claims report; elevate issues and trends to leadership.
• Review and process client sliding scale applications and track for renewal.
• Perform other duties and projects as assigned.

• Bachelor’s degree in Finance, Psychology, Social Work, Counseling, Behavioral Health, or other closely related field highly preferred.
• Minimum 5 years of experience in the healthcare industry (particularly Medicaid and Managed Medicaid insurance companies).
• Minimum of 5 years of Healthcare Revenue Cycle Experience (Auth, Billing, Coding, Collections, Charge Capture).
• Thorough understanding of the authorization process with Medicaid payors.
• Experience with ICD-10 coding. Billing and Coding certification is highly preferred.
• Prior experience with Lean Six Sigma and Process Improvement methodology preferred.
• Experience with Care Logic system preferred.
• Strong understanding of Microsoft applications; i.e. Excel, Outlook, Access, Word.
• Ability to investigate problems and develop/communicate solutions.
• Excellent oral, written, and interpersonal communication skills with a focus on customer service.
• Ability to meet deadlines; highly detailed oriented; strong financial analysis and organizational skills; and analytical mindset with intellectual curiosity.
• Ability to act and operate independently with minimal supervision.

• FREE Virtual Primary Care, Urgent Care, and Mental Health Counseling for ALL Employees
• PAID Maternity/Paternity leave
• Medical Insurance (BCBS of IL)
• Dental Insurance
• Vision Insurance
• Life Insurance
• Long-Term & Short-Term Disability
• Pet Insurance
• FSA (Health, Dependent Care, Transit)
• Telemedicine
• EAP
• 403(b) Retirement Plan with Employer Match

• Mid-Senior level

• Full-time

• Other

• Mental Health Care