Authorization Specialist

5 hours ago


Woodland Hills, California, United States Tarzana Treatment Center Full time
Job Title: Authorization Specialist

At Tarzana Treatment Centers, Inc., we are seeking a highly skilled Authorization Specialist to join our team. As an Authorization Specialist, you will play a critical role in managing contract patient authorization status issues and reporting on relevant measures to suggest and coordinate improvement activities.

Key Responsibilities:

  • Review ASAM assessments and relevant items in the SAGE and AVATAR systems to determine appropriate patient authorization needs.
  • Apply for initial and re-authorizations with SAPC in SAGE (Authorization Form in SAGE and Misc. Note in SAGE) for all levels of care.
  • Communicate with programs to provide Treatment Plan Update upon SAPC request and correspond with SAPC regarding ongoing authorizations as needed.
  • Review appropriate reports for authorization updates and communicate with programs about authorization status, as necessary.
  • Request program transfers and discharges to align with authorizations, as necessary.
  • Input information into both SAGE and AVATAR systems as required for authorization needs. Communicate that information as needed.
  • Review and reconcile denied authorizations from County funding sources and communicate with program staff to reverse denials to maximize revenue for the Drug Medi-Cal contract.
  • Work to automate the review, processing, and reporting of authorizations throughout the organization.
  • Act as an expert on the authorization process for the organization.
  • Work with program staff to review admission and other relevant workflows to improve authorization process and increase approvals.
  • Attend trainings on authorization processes and communicate findings throughout the organization, as necessary.

Requirements:

  • Master's level degree with at least three years of work experience required.
  • 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.

About Us:

Tarzana Treatment Centers, Inc. is a non-profit corporation providing behavioral healthcare services, including chemical dependency. We are an equal opportunity employer and do not discriminate based on age, race, nationality, religion, gender, sexual orientation, or disability in our hiring practices.



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