Deskripsi Pekerjaan
Are you a dedicated professional looking to lead a high-impact healthcare team? We are currently seeking an experienced Prior Authorization Team Lead to oversee our operations in Manila. In this dynamic role, you will be responsible for steering the team, monitoring critical workflows, and ensuring that insurance authorizations are secured promptly for patient treatments. You will act as the bridge between our clinical staff and insurance providers, ensuring compliance and efficiency while maintaining a high standard of patient care.
As the Team Lead, you will drive operational excellence by implementing best practices and fostering a supportive environment for your staff. Your expertise will be crucial in navigating complex insurance requirements, reducing denial rates, and ensuring that treatments are not delayed due to administrative hurdles.
Tanggung Jawab
- Lead, mentor, and supervise a team of prior authorization specialists to ensure high-quality performance and adherence to targets.
- Monitor daily workflows, track authorization requests, and manage queues to guarantee timely processing of patient treatments.
- Analyze performance metrics, including approval rates and turnaround times, to identify bottlenecks and implement process improvements.
- Collaborate with insurance carriers and internal departments to resolve complex authorization issues and expedite approvals.
- Ensure strict adherence to healthcare regulations, payer guidelines, and company policies.
- Conduct regular training sessions and coaching to enhance team skills and product knowledge.
- Prepare and review reports to communicate team performance and progress to management.
Kualifikasi
- Proven experience in a prior authorization or medical billing role, with at least 2 years of experience in a leadership capacity.
- Strong working knowledge of medical terminology, ICD-10, and CPT coding standards.
- Excellent verbal and written communication skills for interacting with payers, healthcare providers, and staff.
- Detail-oriented mindset with strong problem-solving and critical thinking abilities.
- Proficiency in using healthcare management software and CRM systems.
- Ability to manage multiple priorities and work efficiently in a fast-paced, high-volume environment.
- High school diploma or Bachelor’s degree in Healthcare Administration, Business, or a related field is preferred.