Authorizations Representative Lead

Authorizations Representative

Rewarding career. Competitive salary. Outstanding benefits.

The Lead Authorizations Representative is primarily responsible for providing training and ongoing education to the authorization team. This role oversees staff scheduling and supports the team in obtaining prior authorizations for clinic patients, ensuring referrals are processed within the required 72-hour timeframe.

Additionally, the Lead Authorizations Representative collaborates with the Patient Care Access Manager by analyzing performance data, identifying opportunities for improvement, and researching current workflows to enhance efficiency while ensuring compliance with insurance requirements.

Standard expectations include promoting a positive working environment, communicating effectively, and performing duties efficiently and effectively.

Area of responsibility duties and responsibilities include monitoring incoming referral/order requests, confirming clinical documentation, submitting referrals, briefing patients, following through with the referral process, responding to specialty care office requests, and assisting patients in scheduling appointments.

Authorizations duties include assessing authorization requirements, staying up-to-date with insurance payer requirements, submitting authorizations, following up on pending authorizations, responding to insurance companies, informing patients of authorization outcomes, communicating with insurance companies, updating authorization requests, and assisting in scheduling peer-to-peer calls.

Leadership duties include acting as a resource for patients and team members, using insurance company websites, and assisting with workflow and efficiency tracking.

Qualifications include one or more years of experience working with insurance verification, and preferred experience as an Authorizations Representative, working in a medical office setting, and with the patient registration process.

Work environment and physical demands include working primarily in an office environment, with occasional standing, walking, lifting, reaching, carrying, kneeling, bending, stooping, pushing, and pulling of objects weighing up to 20lbs, and continuous finger dexterity and fine manipulation.

Position details include 40 hours per week, regular full-time status, day shift, and a pay range of $22.00 - $38.50, with actual pay offered varying based on years of experience.

Employee benefits include medical, dental, vision, life insurance, and retirement options, medical insurance coverage beginning on day one, discounts on medical services provided by Whitman Hospital and Medical Clinics, differentials for evening, night, and weekend shifts, and a unique PTO plan enabling accrual increase with each year of service.