Job Overview:

The Authorizations Supervisor is responsible for overseeing the processing of all authorizations and communication with providers in regard to authorizations. The Authorizations Supervisor will also oversee all types of non-clinical authorization changes requested by Care Manager.

Essential Responsibilities:

Oversee Authorization process o Ensure no authorizations are issued for non-active members o Any other supervisory duties for authorization department o Be able to analyze and report monthly on the authorizations to finance with certain matrixes. Work together with Director of DME o Ensure notices are sent timely, authorizations closed when necessary, accurate notices sent o ensure workflows and productivity is up to par Take charge of all unbilled inpatient and SNF stays to be reported to finance Take charge of Claims processing (potentially) Runs weekly management reports Monitors auth file transfer from GC to QNXT Completes monthly compliance dashboard Works closely with the UM team to ensure authorizations are processed as needed Tracks auth queues on a daily basis to ensure activities are completed in a timely manner Submits and follows up on system service request tickets Provides support to members of the department and supports various department functions Create spreadsheets with appropriate data, as requested and assigned Assists staff within team to facilitate workflow and ensure efficient service to our members Assists in streamlining the workflow process for all LOB's Works hand in hand with Finance department to ensure accuracy of authorizations Submit monthly authorization summary report to Finance Ensure authorizations are set up prior to the 1st for new enrollments Works with various departments (PR,CM,HC) whenever services needs to changed from one provider to another. Other activities as directed

Specific Knowledge, Skills, and Abilities:

Proficient in the use of office equipment and the computer; Microsoft Word and Excel. Self-directing, good organizational and interpersonal skills.

Word Processing/Spread Sheets, Data Entry Benefits:

Medical, dental, and vision insurance Generous PTO package Multiple floating holidays 401 (K) with employer contribution