Authorization and Integration Specialist

WE ARE TITANIUM HEALTHCARE

Titanium is a healthcare company that puts heart and compassion above all else. Millions of Americans just aren’t getting the medical care they need. We’re on a mission to change that. For patients that means exceptional support and better care. For providers it means better support and time to focus on patients, and for partners that means higher quality and lower cost.

Join us in our mission!

SUMMARY

The Authorization & Integration Specialist will support the development, integration, and ongoing improvement of authorization processes within Revenue Cycle. This position is responsible for complex authorization workflows, payer and program requirements, operational integration, and initiatives designed to improve authorization accuracy, timeliness, and reimbursement outcomes.

The Authorization & Integration Specialist serves as a subject matter resource for authorization-related processes and works across Revenue Cycle, Operations, Finance, Data, and other internal teams to identify process gaps, resolve complex issues, develop effective workflows, and support the continued integration of authorization functions within Revenue Cycle.

This position leads complex Revenue Cycle projects, process improvement initiatives, and provides oversight of Community Supports housing deposit processes.

WHERE YOU’LL WORK

This position is hybrid and based out of our Garden Grove office.  Standard business hours are Monday through Friday from 8:00 am to 5:00 pm. 

WHAT YOU’LL DO

Authorization Process & Integration

• Support the development, implementation, and integration of authorization workflows within Revenue Cycle
• Manage and support complex authorization processes to ensure required services are appropriately authorized within payer-required timeframes
• Monitor authorization workflows, work queues, turnaround times, missing or expiring authorizations, and outstanding requests to identify trends and opportunities for improvement
• Research and interpret payer authorization requirements and ensure requirements are accurately documented and incorporated into established workflows
• Partner with operational teams to resolve missing, incomplete, or expiring authorizations that may affect billing and reimbursement
• Identify recurring authorization issues that contribute to claim denials, delayed reimbursement, or other Revenue Cycle impacts
• Collaborate with payers, Revenue Cycle, and operational teams to resolve complex authorization barriers and process issues
• Develop and improve processes designed to reduce authorization-related denials and prevent avoidable revenue loss
• Support the transition and integration of authorization functions into Revenue Cycle, including development of workflows, documentation, controls, and cross-functional processes
• Support authorization processes associated with new payers, contracts, programs, services, and changing payer requirements
• Serve as a subject matter resource for authorization processes, workflows, and payer requirements

Process Improvement & Complex Projects

• Lead and coordinate complex authorization and Revenue Cycle projects, including workflow implementations, payer-related initiatives, process improvement efforts, system enhancements, and other operational initiatives as assigned
• Develop project plans, coordinate stakeholders, monitor timelines and deliverables, identify barriers, and drive assigned projects through completion
• Analyze authorization processes, operational data, and performance trends to identify opportunities to improve efficiency, accuracy, reimbursement, and financial performance
• Develop and implement workflow improvements designed to strengthen operational controls, improve authorization outcomes, and reduce preventable denials and revenue leakage
• Assist with the development, implementation, and documentation of Revenue Cycle policies, procedures, workflows, and process standards
• Support new or changing payer, program, system, and operational requirements affecting authorization functions
• Partner with Revenue Cycle, Finance, Data, and operational leadership to research and resolve complex issues affecting authorization, reimbursement, or operational performance

Community Supports Housing Deposits

• Oversee the processing and tracking of housing-related deposits associated with Community Supports services
• Partner with Community Supports, Finance, and other internal teams to ensure housing deposit requests are complete, accurately documented, and processed timely
• Monitor outstanding or unresolved housing deposit items and coordinate follow-up through resolution
• Identify recurring issues, workflow gaps, or reconciliation concerns and support improvements to the housing deposit process

Cross-Functional Support

• Partner with the Authorization & Denial Specialist and other Revenue Cycle team members to support consistent authorization processes and resolve complex authorization issues
• Provide guidance and subject matter expertise regarding authorization requirements, workflows, and process changes
• Develop resources, documentation, and training materials to support consistent implementation of authorization processes across teams
• Communicate process changes, payer requirements, and identified issues to appropriate stakeholders
• Perform other duties and projects as assigned

WHO YOU ARE

• Strong understanding of healthcare authorization processes and how authorizations affect billing, denials, reimbursement, and overall Revenue Cycle performance
• Able to evaluate complex processes, identify gaps and root causes, and develop practical solutions
• Comfortable interpreting payer requirements, translating into clear and effective operational workflows
• Analytical and able to interpret Revenue Cycle information, identify trends, and recognize opportunities for improvement
• Highly organized and able to manage multiple priorities, deadlines, and complex projects simultaneously
• Strong attention to detail and a commitment to accuracy, confidentiality, and compliance
• Exercise sound judgment and can work independently within established policies and procedures
• Communicate clearly and effectively with employees, leaders, payers, and cross-functional partners
• Collaborate effectively across departments and are comfortable influencing processes without direct supervisory authority
• Comfortable learning and working within electronic health record, practice management, billing, and other healthcare technology systems
  

Sensory Requirements

• Fluent in English (written and verbal)
  
• Ability to communicate clearly in-person, by phone, and electronically
• Adequate hearing and vision (with corrective devices if necessary) to conduct assessments and documentation
  
• Ability to identify problems and use logic and related information to develop and implement solutions
• Excellent organizational skills and attention to detail
• Commitment to maintaining patient confidentiality and adhering to ethical standards in healthcare practice

Physical Activity

• Must be able to remain in a stationary position
• Must be able to move around the office and/or travel throughout community
• Ability to operate a vehicle and travel to meet with members around the community; attend meetings and events as required or requested

Environmental Conditions 

• Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures

Technology Use

• Frequent use of computers, keyboard, and handheld/mobile devices
• Ability to type for extended periods
• Competent with computers, email, virtual platforms, and Microsoft Office based programs

WHAT YOU’LL NEED

• High school diploma or GED required
• Minimum of 5 years of experience in healthcare revenue cycle, insurance authorizations, medical billing, reimbursement, practice management, or related healthcare operations
• Demonstrated experience working with insurance authorization processes and payer requirements
• Experience working with electronic health record (EHR), practice management, and/or medical billing systems
• Working knowledge of healthcare reimbursement processes and the relationship between authorizations, claims, denials, and reimbursement
• Experience developing, implementing, or improving healthcare operational workflows and processes
  

• Distraction-free home workspace with a secure internet connection

NICE TO HAVES

• Associate or bachelor's degree in healthcare administration, business administration, finance, or related field
• Experience with Medi-Cal managed care and payer requirements
• Experience supporting CalAIM programs, including Enhanced Care Management (ECM) and Community Supports (CS)
• Experience with authorization-related denials and denial prevention
• Experience integrating or centralizing authorization functions within a healthcare organization
• Experience leading cross-functional projects or Revenue Cycle process improvement initiatives
• Experience with eClinicalWorks (eCW)
  

WHAT YOU’LL ENJOY

• Make an impact: an organization who cares about its employees, communities, and the future of healthcare
• Inclusivity: be a part of a workplace where you not only belong but also can be the best version of yourself
• Growth: opportunities to develop and grow your career with us
• Community: you are encouraged to have a voice, share your opinions, and have an individual impact on the business
• Paid Time Off: 12 holidays and up to 15 days of accrued PTO to rest and recharge plus additional time for sick, jury duty, bereavement, reproductive loss, and therapy
• Work Life Balance: enjoy flexibility to maximize your well-being and success with our hybrid work model
• Medical, Dental, & Vision Benefits: we cover up to 100% of your premium and 50% of your dependents depending on the plan
• Prioritize your mental health with unlimited therapy sessions funded 100% by Titanium Healthcare
• Flexible Spending, Health Savings & Dependent Care Accounts
• Life/AD&D insurance funded 100% by Titanium Healthcare
• Supplemental Short-Term Disability

• Employee Assistance Programs
• Protect your pet(s) with Pet Insurance
• 401(k) plan 

EEO Statement

At Titanium Healthcare, our mission is to fearlessly reengineer the way healthcare works to reduce costs, ensure better outcomes, and provide everyone, everywhere, with the kind of compassionate and coordinated care they deserve. We believe that achieving this mission starts with a diverse and inclusive workforce.

Titanium Healthcare is an equal opportunity employer. We are committed to promoting and celebrating all backgrounds and encourage all applicants, regardless of race, religion, gender, sexual orientation, disability, age, marital status, parental status, military or veteran status, or any other legally protected status, to apply. We believe that diversity and inclusion drive innovation and equity in healthcare, enabling us to better serve our communities and make a lasting impact.