Lead Pre-Service / Pre-Certification Specialist

Job Details Level: Experienced • Location: West Atlantic City, NJ 08232 • Position Type: Full Time • Education Level: High School • Salary Range: $24.50 - $28.50 per hour • Travel Percentage: None • Shift: Day • Category: Admin - Clerical Responsibilities Serves as principal contact for AMI and the pre‑authorization department staff regarding prior authorization processes at all AMI locations. Advises referring providers and their clinical staff on issues related to obtaining pre‑authorization. Maintains a current knowledge base of insurance requirements for pre‑authorization and serves as the primary resource on these requirements. Works closely on the implementation and maintenance of the pre‑authorization platform (e.g., Gravity). Collaborates with clinical staff and billing on issues related to prior authorization and reimbursement. Communicates often with the Director of Administrative Services to monitor daily workflows. Trains new department employees and alerts the APS team to changes in current workflows or processes. Works with the Director of Administrative Services to develop and implement quality control measures; monitors program area performance focusing on accuracy, timeliness, and productivity. Monitors productivity to optimize utilization of staff resources, including staff working from home. Ensures workload is distributed fairly and balanced across the department, rotating assignments as needed. Completes weekly payroll and manages PTO requests; maintains a Time Off calendar to ensure appropriate coverage; assigns APS team members to worklists requiring additional support. Performs other duties as assigned. Qualifications High school diploma or equivalent. Prior leadership experience required. At least two (2) years of professional experience in pre‑authorization processes. Medical terminology, insurance knowledge, and experience working with referring physicians required. Proficiency and familiarity with EviCore, NaviNet, insurance platforms, EMR, and Microsoft Office Suite. Leadership qualities and the ability to lead by example in communication, service, and work quality. Exceptional verbal and written communication skills. Willingness to occasionally work on‑site for meetings and training. Schedule & Location Full time, 40 hours per week; Monday‑Friday, 7:30am–4:00pm; on‑site at the AMI Corporate Office in West Atlantic City / Pleasantville, NJ. Schedules and locations are subject to change based on business or department needs. Benefits Generous compensation and benefits package including medical, prescription, dental, vision, flexible spending accounts, Paid Time Off (PTO), Paid Holidays, 401(k), and profit sharing. Rates increase based on years of experience. Equal Opportunity Employer EOE #J-18808-Ljbffr