Authorization Specialist – Clinical Documentation Reviewer
Job description
Position Title:
Authorization Specialist
Department:
Quality Assurance
Reports To:
QA Supervisor
POSITION SUMMARY
Under the general supervision of the Quality Assurance Supervisor, the Authorization Specialist focuses on managing contract patient authorization status issues. This position is also responsible for reporting on relevant measures and suggesting and coordinating improvement activities when directed.
SALARY RANGE
$26.50 - $40 / hour DOE
We offer a competitive benefits package:
- Medical Insurance
- Dental Insurance
- Vision Care Plan
- Life Insurance
- Paid Holidays (12)
- Paid Vacation Time
- Sick Time
- 401(k) Retirement Plan
- Competitive wages
- Stability and career advancement
- Continuing Education Opportunities
HOURS
40 per week, Monday-Friday
CATEGORIES OF DUTIES
- Reviews ASAM assessments and relevant items in the SAGE and AVATAR systems to determine appropriate patient authorization needs.
- Applies for initial and re-authorizations with SAPC in SAGE (Authorization Form in SAGE and Misc. Note in SAGE) for all levels of care.
- Communicates with programs to provide Treatment Plan Update upon SAPC request and correspond with SAPC regarding ongoing authorizations as needed.
- Reviews appropriate reports for authorization updates and Communicates with programs about authorization status, as necessary.
- Requests program transfers and discharges to align with authorizations, as necessary.
- Inputs information into both SAGE and AVATAR systems as required for authorization needs. Communicates that information as needed.
- Reviews and reconciles denied authorizations from County funding sources and communicates with program staff to reverse denials to maximize revenue for the Drug Medi- Cal contract.
- Works to automate the review, processing and reporting of authorizations throughout the organization.
- Acts as an expert on the authorization process for the organization.
- Works with program staff to review admission and other relevant workflows to improve authorization process and increase approvals.
- Attends trainings on authorization processes and communicates findings throughout the organization, as necessary.
- Performs other related duties as assigned by CEO, Director of Information Technology or QA Supervisor.
EDUCATION/TRAINING/EXPERIENCE
Master’s level degree with at least three years of work experience. Must be licensed or licensed-eligible. Prior experience in auditing and/or quality assurance in a healthcare setting. Knowledge of Los Angeles Department of Public Health, authorization processes preferred.
SETTING
Tarzana Treatment Centers, Inc. is a non-profit corporation, which provides behavioral healthcare services, including chemical dependency.
EQUAL OPPORTUNITY EMPLOYER
Tarzana Treatment Centers, Inc. does not discriminate as to a g e , race, nationality, religion, gender, sexual orientation and disability in its hiring practices.
ADA REQUIREMENT
Tarzana Treatment Centers, Inc. supports the American with Disabilities Act. Discrimination is prohibited in all aspects of employment against disabled persons, who, with reasonable accommodations, can perform the essential functions of a job.
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