Precertification Supervisor

Implement and support OSUWMC's mission, values, standards, policies, and procedures Lead daily operational workflow for the precertification department Hire new staff and complete scorecards, performance reviews, and corrective action as needed Oversee training and onboarding of new team members Lead multidisciplinary efforts to secure complex pre-authorizations and prevent or appeal clinical denials Interpret and apply medical necessity guidelines to determine appropriate services Become a subject matter expert for insurance carriers and governmental payers Provide accurate, up-to-date insurance benefits and authorization information to clinical staff and patients Ensure accurate appointment, demographic, and insurance information is gathered Support physicians and customers by coordinating requests and resolving routine and complex problems Communicate regularly with clinical teams, medical staff, and other team members Determine the most appropriate communication method for obtaining authorizations Use electronic transactions, web portals, phone calls, and faxes to obtain authorizations Requirements Bachelor's degree or equivalent experience 3 years of relevant experience required 4–8 years of relevant experience preferred Experience with Windows, Excel, and intranet/internet navigation tools preferred Medical terminology, coding, and third-party reimbursement experience preferred Ability to work in multiple systems for assigned tasks, management, and reporting Strong problem-solving and presentation skills High level of customer service skills Ability to prioritize and coordinate multiple tasks in a busy environment Clinical knowledge to interpret and apply medical necessity guidelines Ability to use electronic medical records, scheduling and registration systems, ABN, eligibility, and document management software Ability and willingness to learn new technology Ability to obtain authorizations through electronic transactions, web portals, phone calls, and faxes Core Competencies Demonstrates expertise in managing precertification processes, including securing pre-authorizations and applying medical necessity guidelines. Proficient in coordinating multidisciplinary efforts and providing exceptional customer service in a clinical environment. Highest-signal resume keywords Precertification Management Medical Necessity Guidelines Insurance Authorization Processes Customer Service Skills Team Leadership Hard Skills Medical Terminology Coding Third-Party Reimbursement Electronic Medical Records Scheduling Systems Document Management Software Data Management Performance Reviews Problem-Solving Presentation Skills Soft Skills Strong Communication Ability to Prioritize Coordination Skills Adaptability Team Collaboration Industry Keywords Pre-Authorizations Clinical Denials Insurance Carriers Governmental Payers Patient Coordination Tools & Technologies Windows Excel Intranet Navigation Web Portals Electronic Transactions Faxes Phone Communication #J-18808-Ljbffr Jobtailor