Centralized Authorization Team Lead

White-Wilson Medical Center,P.A.•Fort Walton Beach, FL

2d•Onsite

About The Position

The Referral and Authorization Team Lead is responsible for overseeing the authorization process for medical services and treatments. This role ensures that all necessary approvals are obtained from insurance companies and other payers, facilitating smooth and timely patient care. The Team Lead will manage a team of specialists, ensuring compliance with all relevant regulations and policies, and will work closely with healthcare providers, payers, and patients to resolve any issues related to authorizations and referrals.

Requirements

Proven experience in healthcare administration, particularly in referrals and authorizations.
Strong knowledge of insurance procedures and regulations.
Excellent organizational and leadership skills.
Ability to manage and motivate a team.
Effective communication and problem-solving skills.
Detail-oriented with a focus on accuracy and efficiency.
High School Diploma or GED equivalent with courses to include typing, business English and office procedures or completion of vocational training for medical office.
Minimum of two years’ experience in a medical office.

Nice To Haves

Certified Medical Assistant or Nursing certification strongly preferred.
Pre-certification experience strongly preferred.

Responsibilities

Oversee and manage the referral and authorization process for medical services.
Confirm the patient's insurance coverage and benefits.
Ensure timely and accurate submission of authorization requests to insurance companies and other payers.
Supervise and support a team of referral and authorization specialists.
Monitor the status of authorization requests and follow up as necessary.
Collaborate with healthcare providers, payers, and patients to resolve any issues related to authorizations and referrals.
Assign tasks and ensure team productivity.
Ensure compliance with all relevant regulations and organizational policies.
Provide training and ongoing support to team members.
Implement process improvements to enhance efficiency and accuracy in the authorization process.
Address complex authorization issues and escalate when necessary.
Create and revise training materials and standard operating procedures (SOPs) for the team.
Track key performance indicators and report team performance to management.
Analyze authorization trends to identify areas for improvement.
Performs related duties as required.
Regular and reliable attendance required.