Insurance and Prior Authorization Manager

Position Details

• Location: Northbrook, IL
• Schedule: Full-Time, Monday-Friday (on-site)
• Compensation: $70,000-$85,000 based on experience and qualifications

Responsibilities

• Maintain positive leadership and give frequent performance feedback to team members and invite two-way communication
• Coach established employees when needs are identified, holding employees accountable for results through coaching and development of action plans
• Monitor Prior Authorization and Eligibility automation processes
• Aid IT team in developing new automation processes for authorization submission/tracking and insurance verification
• Work closely with billing team for claim denials related to authorization and eligibility
• Produce productivity and error reports to assess staff
• Prioritize work to maximize turn-around time
• Contact insurance plans to determine eligibility and obtain coverage and benefit information
• Contact insurance plans to obtain prior authorization for services
• Document findings thoroughly and accurately
• Perform training with organizational staff on procedures for requesting, documenting, and processing prior authorizations

Requirements

• High school diploma or equivalent required
• Bachelor's degree with specialization in health information administration preferred
• 3 years medical authorization experience required
• Strong background and experience in Revenue Cycle Management preferred
• 2+ years in a leadership role required
• Active knowledge of CMS guidelines contracted insurance guidelines and coding policies
• Excellent verbal and written communication skills
• Detail oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment
• Demonstrated computer literacy and excellent math skills
• Ability to maintain a high level of confidentiality and professionalism