Service Coordinator
To provide administrative and clinical coordination support to both the Clinical Director and Administrative Director to ensure effective oversight of intake, referral and service integration processes. This role supports quality assurance through clinical documentation review, assists with payer-related prior authorizations, and coordinates workflows among admissions, clinical, and billing teams to ensure clients access behavioral health services in a timely and compliant manner.
The Service Coordinator functions as a key liaison between the Admissions Department, Clinical Department, and Billing Department, maintaining compliance with internal procedures, payer requirements, and client-centered care standards.
QUALITY AND ADMINISTRATIVE COORDINATION
· Provide administrative and operational support to the Administrative Director for oversight of admissions, documentation tracking, and workflow coordination.
· Support the Clinical Director in reviewing intake and assessment documentation for completeness, clinical appropriateness, and compliance with quality standards.
· Ensure all documentation required for payer approval and clinical readiness is received, reviewed, and filed appropriately.
· Maintain logs and tracking systems for referrals, documentation, and service coordination tasks.
· Participate in interdepartmental meetings to identify process improvements and workflow efficiencies.
PRIOR AUTHORIZATION AND SERVICE ACCESS
· Review clinical documentation to determine eligibility for services requiring prior authorization.
· Prepare and submit prior authorization requests to Medicaid, managed care organizations, and other payers in accordance with their guidelines.
· Track and maintain documentation of authorization approvals, units, and renewal dates to prevent service interruptions.
· Communicate authorization outcomes, requests for additional information, and denials to appropriate staff and supervisors.
· Collaborate with the Billing Department to ensure proper billing alignment with authorization approvals.
· Report on approved services, authorization status, and utilization to the Administrative and Clinical Directors on a regular basis.
· Assist with insurance appeals and resubmissions as needed to support the approval of services and continuity of client care.
REFERRAL AND WORKFLOW COORDINATION
· Collaborate closely with the Admissions Coordinator and Admissions Assistants to facilitate the workflow process for referrals into appropriate programs and services.
· Coordinate with clinicians, supervisors, and program leads to assign clients based on clinical need, eligibility, and payer coverage.
· Ensure smooth transition from intake to ongoing clinical services through timely communication and verification of required authorizations.
· Identify workflow barriers or delays in service activation and communicate these to the Administrative or Clinical Director as appropriate.
· Maintain effective communication between departments to promote integration and continuity of care.
DOCUMENTATION, DATA AND COMPLIANCE
· Maintain accurate and current records within the Electronic Health Record (EHR) related to referrals, authorizations, and service coordination activities.
· Ensure compliance with HIPAA, agency confidentiality standards, and payer requirements.
· Generate reports and summaries for leadership related to authorization activity, intake quality indicators, and pending documentation.
· Assist in preparation for internal audits, payer reviews, or quality improvement assessments.
· Participate in ongoing training and supervision to stay current with changes in documentation and authorization procedures.
CUSTOMER SERVICE DUTIES
· Responds and attends to inquiries from clients/guardians, other agencies/individuals, independent contractors, etc.
regarding assignment of cases.
· Communicates with other departments, case workers, and various referral sources.
· Works in cooperation with other departments within the agency.
OTHER DEPARTMENT DUTIES AS ASSIGNED
· Attends and participates in staff development training and workshop.
· Enters data as required in Lauris Electronic Medical Records System.
· Generates correspondence as required.
· Other department duties as assigned.