Prior Authorization Team Lead
2 weeks ago
About the job Prior Authorization Team Lead
HRRMC's Patient Financial Services Department has a full time Prior Authorization Team Lead, working 40 hrs/ week : Monday - Friday. T
Provides technical, hands on knowledge and support for the authorization team. Participates with on-boarding/mentoring as assigned. Is a resource to employees by assisting with problem solving and answering questions. The team lead assists in overseeing daily operations for quality and
policy compliance, providing quality customer service and facilitating real-time resolution to any customer concerns. Works assigned reports/ tasks and helps support the manager as needed.
Apply on line www.hrrmc.com
Essential Duties per area of responsibility:
1. Assists the Billing Manager, Billing Supervisor, and PFS Director with special projects, training, account review and internal auditing of any and all accounts receivables with a primary focus to ensure all accounts are authorized/ cleared correctly and accurately in a timely manner.
2. As occurs, advise the Billing Manager of any opportunities, issues, or concerns that impact accounts receivable and authorization.
3. Serve as a mentor for authorization staff to help them become more efficient and productive.
4. Consistently works on streamlining the workflow processes to ensure the most efficient experience for staff and customers.
5. Is proficient in CPSI and APRIMA, serving as a "Super-User" in applications utilized.
6. Perform the following duties on a daily basis as or determined by Billing Manager
•Jump in and help clear the authorization queues/tasks as needed
•Provide backup coverage for any authorization position as needed
•Provide additional training for all staff as processes change.
•Escalate denied authorization to scheduling to cancel two days before
scheduled visit.
•Route medical necessity emails to clinic leadership and attach the current
LCD.
•Review surgery schedule for next day and provide status if all cleared or
escalated issues.
7. Performs other duties consistent with the above responsibilities as directed.
EDUCATION and/or EXPERIENCE
•2 years prior authorization experience
Benefitsinclude Medical, Dental, and Vision Insurance, Life and AD&D InsurancePolicies, LTD Policy, Flex Spending Account, Employee Assistance Program,REACH Air Membership, Employer Matching Retirement Funds and Paid Time Off.
Alloffers of employment are contingent upon the successful completion of anegative drug screen test*, criminal background check, reference checks, andinfection prevention procedures: TB test, Flu Shot, immunization records, andacknowledgement of policies.
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