Authorizations Team Lead

Job Description

Job Description

Lead a high‑impact team that keeps patient care moving forward. Are you a detail‑driven problem solver with strong knowledge of payer rules, coding, and medical necessity? Do you love improving processes, guiding teams, and making healthcare operations run smoothly? If so, this is the role for you!Bone & Joint is seeking a Prior Authorizations Team Lead to support and elevate our surgical, clinic, and physical therapy authorization operations. This role is essential to ensuring accurate, timely, and compliant authorizations that protect revenue and keep patient care on track. What You'll Do As our Authorizations Team Lead, you will:

• Guide and support the Prior Authorizations team in processing surgical, PT, and clinic authorizations
• Ensure authorizations are accurate, compliant, and submitted timely
• Stay on top of payer rules, CPT/HCPCS codes, and medical necessity guidelines
• Monitor turnaround times, trends, and potential bottlenecks
• Identify process improvements that reduce denials and optimize revenue
• Collaborate with Coding, Billing, and Clinical teams to support clean documentation
• Train, mentor, and onboard new and existing staff
• Support hiring, evaluations, and workflow optimization
• Serve as backup when the Supervisor is out of office
• Travel to Bone & Joint locations as needed for onsite leadership

• High school diploma required; associate degree preferred
• 2+ years' experience in prior authorizations, billing, coding, or revenue cycle
• Coding certification (CPC, COC, etc.) preferred
• Strong understanding of payer rules & medical necessity
• Analytical mindset with experience in reporting & trend analysis
• Proven leadership or mentorship experience
• Excellent communication, organization, and problem‑solving skills
• Proficiency with Microsoft Office and PM/EHR systems
• Valid WI driver's license