Authorization Manager

Overview

This position manages the Authorization Specialist and performs the job duties as a working manager when needed. It oversees the day-to-day operations of the authorization and insurance verification team, manages productivity and performance, and acts as the primary liaison for all insurance verification and authorization matters.

Responsibilities

• Manage and sometimes performs the daily job duties of subordinate positions when needed.
• Manage the day-to-day operations of the authorization and insurance verification team.
• Oversee and manage productivity and performance of assigned employees including daily/weekly/monthly department metrics to Senior Leadership.
• Maintains positive leadership and gives frequent performance feedback to subordinates and invites two-way communication.
• Coaches established employees when needs are identified, holding employees accountable for results through coaching and development of action plans.
• Monitor and manage key performance indicators and data for department, and provide reporting and action plans for improvement.
• Prioritize work to maximize turn-around time.
• Ensures staff are calculating accurate quotes for patient surgery benefits.
• Processes request for prior authorization from clinics and care team.
• Performs training with organizational staff on procedures for requesting, documenting and processing prior authorizations.
• Answers and respond to external and internal phone calls in a timely manner.
• Checks and respond to emails in a timely and professional manner.
• Maintains a high level of customer service and professionalism with operations, working to establish a positive rapport with the clinics.
• Communicates performance data and action plans to leadership.
• Performs all other assigned duties.

Qualifications

• Education: High School diploma or equivalent
• Prior Experience: 5 years medical authorization experience or related billing experience, Ophthalmology background desired, 3 years or more in a leadership role preferred
• Skills And Proficiencies: Manager or above level leadership experience for medium to large team in healthcare setting, the ability to motivate and lead a team, experience in revenue cycle management, active knowledge of CMS guidelines contracted insurance guidelines and coding policies, demonstrated computer literacy, well-organized with attention to detail, ability to read and understand oral and written instructions, excellent math skills, ability to establish and maintain effective working relationships with team members, clinic staff, payers and patients, professional customer service skills, have a desire and dedication to work with self-discipline, maintains the strictest confidentiality: adheres to all HIPAA guidelines and regulations