Position Title:

Authorization Specialist II

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 - $37 per 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

1. Reviews ASAM assessments and relevant items in the SAGE and AVATAR systems to determine appropriate patient authorization needs.
2. Applies for initial and re-authorizations with SAPC in SAGE (Authorization Form in SAGE and Misc. Note in SAGE) for all levels of care.
3. Communicates with programs to provide Treatment Plan Update upon SAPC request and correspond with SAPC regarding ongoing authorizations as needed.
4. Reviews appropriate reports for authorization updates and Communicates with programs about authorization status, as necessary.
5. Requests program transfers and discharges to align with authorizations, as necessary.
6. Inputs information into both SAGE and AVATAR systems as required for authorization needs. Communicates that information as needed.
7. 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.
8. Works to automate the review, processing and reporting of authorizations throughout the organization.
9. Acts as an expert on the authorization process for the organization.
10. Works with program staff to review admission and other relevant workflows to improve authorization process and increase approvals.
11. Attends trainings on authorization processes and communicates findings throughout the organization, as necessary.
12. Performs other related duties as assigned by CEO, Director of Information Technology or QA Supervisor.