Preauthorization Supervisor

Job Type: Officer of Administration Bargaining Unit: Regular/Temporary: Regular End Date if Temporary: Hours Per Week: 35 Standard Work Schedule: Building: Salary Range: $78,000.00 - $85,000.00 The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting. Position Summary The Preauthorization Supervisor is responsible for the oversight and daily operations of the authorization and referral functions supporting Interventional Radiology services across Columbia Radiology and affiliated NYP practices, including Manhattan and Westchester IR locations. This role supervises authorization staff, ensures timely and accurate payer authorization processing, manages complex escalation cases, and drives operational efficiency related to insurance verification, referrals, pre-certifications, denials management, and reimbursement workflows. The Supervisor serves as the departmental subject matter expert for payer authorization requirements, medical necessity guidelines, and IR procedural authorization workflows. This position collaborates closely with physicians, procedural schedulers, nursing teams, surgical coordinators, revenue cycle leadership, and payers to ensure timely patient clearance and minimize delays in care or reimbursement. The Authorization and Referral Supervisor is responsible for staff development, quality assurance, productivity monitoring, workflow optimization, reporting, and maintaining compliance with organizational, payer, state, and federal regulations. Responsibilities Supervise the daily operations of the IR authorization and referral team, including workflow management, productivity oversight, staffing coverage, and work assignment distribution. Oversee authorization workflows and operational coordination for Interventional Radiology practices across Manhattan and Westchester locations, ensuring standardized processes, timely authorizations, and consistent staff performance across sites. Manage referral and authorization work queues to ensure timely processing, appropriate follow-up, and patient outreach to confirm all patients are contacted regarding authorization status, required documentation, scheduling updates, or insurance-related issues. Monitor authorization work queues to ensure timely processing of urgent, elective, and complex Interventional Radiology procedures. Serve as the primary escalation point for complex payer authorization issues, peer-to-peer review coordination, denied services, retro-authorizations, and medical necessity disputes. Research, analyze, and resolve complex authorization, referral, and insurance-related issues requiring critical thinking and independent judgment. Ensure accurate verification of insurance eligibility, benefits, network participation, referral requirements, and authorization requirements for IR procedures and related services. Oversee submission of clinical documentation and authorization requests through payer portals, electronic systems, and direct payer communication. Partner with physicians, APPs, nurses, schedulers, and revenue cycle teams to facilitate timely patient clearance and reduce delays or cancellations related to authorization issues. Review and monitor authorization denials, identify denial trends, and implement corrective action plans to improve approval rates and reimbursement outcomes. Coordinate and oversee appeals processes for denied authorizations and denied claims related to Interventional Radiology services. Provide day-to-day guidance, mentorship, and operational support to junior authorization specialists and team members. Develop, implement, and maintain departmental workflows, policies, training materials, and standard operating procedures. Conduct quality assurance audits to ensure accuracy, compliance, documentation integrity, and adherence to payer requirements. Monitor staff performance metrics including turnaround times, authorization accuracy, denial rates, productivity benchmarks, and service-level expectations. Assist with onboarding, training, coaching, and performance management of authorization staff. Provide ongoing education to staff regarding payer updates, regulatory changes, coding requirements, and authorization guidelines. Collaborate effectively with staff and leadership across all levels of the organization, including physicians, administrators, operational leadership, and external payer representatives. Collaborate with leadership to identify operational improvement opportunities and support departmental initiatives, projects, and system implementations. Generate and maintain reports related to authorization volumes, denials, appeals, payer trends, and operational performance metrics. Ensure compliance with HIPAA, organizational policies, payer regulations, and accreditation standards. Support escalation management involving urgent add-on procedures, inpatient conversions, and high-acuity IR cases requiring expedited authorization review. Participate in departmental meetings, revenue cycle initiatives, and cross-functional operational planning activities. Perform other related duties and special projects as assigned. Minimum Qualifications Bachelor's degree or equivalent in education and experience, Minimum of 3 years of experience in healthcare insurance authorization, revenue cycle, managed care, physician billing, or related healthcare operations required. Preferred Qualifications Minimum of 4-5 years of experience in healthcare insurance authorization, revenue cycle, managed care, physician billing, or related healthcare operations required. Interventional Radiology, Radiology, Surgical Services, or specialty procedural authorization experience strongly preferred. Demonstrated knowledge of CPT/HCPCS coding, ICD-10 diagnosis coding, medical terminology, and payer medical necessity guidelines preferred. Previous experience in an academic medical center or large healthcare organization preferred. Other Requirements Demonstrated experience managing complex authorization cases, insurance escalations, denials, appeals, and medical necessity reviews. Strong working knowledge of insurance eligibility verification, managed care requirements, referral processes, prior authorizations, and denial management. Experience supporting procedural or surgical specialties required. Excellent written, verbal, and interpersonal communication skills. Ability to adapt to changing payer requirements, operational priorities, and departmental needs. Strong attention to detail and commitment to accuracy and compliance. Ability to exercise sound judgment and make independent decisions in high-volume and time-sensitive situations. Ability to foster a collaborative, customer service-focused team environment. Equal Opportunity Employer / Disability / Veteran Columbia University is committed to the hiring of qualified local residents. #J-18808-Ljbffr