Pre-Certification Specialist Lead

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Directs and supervises Pre-Certification Specialists, including hiring, onboarding, scheduling, and performance evaluations.
• Maintains daily workflows to ensure timely and accurate completion of patient access functions.
• Provides coaching and feedback to staff to maintain high standards of service and productivity.
• Trains staff in areas such as Check-in/out, Chart Auditing, Call Center, Scheduling, Insurance Verification, and Authorization submission.
• Maintains adherence to HIPAA and other regulatory requirements, reviews and audits patient access processes for accuracy and efficiency.
• Collaborates with other departments to resolve issues and improve workflows.
• Promotes a culture of excellent patient service by modeling and reinforcing positive behaviors.
• Handles escalated patient concerns and resolves issues promptly and professionally.
• Prepares and analyzes reports related to patient access performance metrics.
• Ensures compliance with organizational standards and payer requirements.
• Participates in departmental meetings and organizational initiatives.
• Performs other related duties as assigned.

Requirements

• High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
• Minimum 2–3 years of experience in patient access or healthcare registration.
• Prior supervisory or leadership experience preferred.
• Strong leadership and team-building skills.
• Excellent communication and interpersonal abilities.
• Proficiency in scheduling systems, insurance verification, and authorization processes.
• Proficient in leveraging technology to optimize workflows, ensure data accuracy, and support efficient patient access operations.
• Able to manage multiple priorities in a fast-paced environment.

Qualifications

• Education: High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
• Experience: Minimum 2–3 years of experience in patient access or healthcare registration.

Skills

• Prior supervisory or leadership experience preferred.
• Strong leadership and team-building skills.
• Excellent communication and interpersonal abilities.
• Proficiency in scheduling systems, insurance verification, and authorization processes.
• Proficient in leveraging technology to optimize workflows, ensure data accuracy, and support efficient patient access operations.

Physical Demands

• Hearing: Adequate to perform job duties in person and over the telephone.
• Speaking: Must be able to clearly communicate in person and over the telephone.
• Vision: Visual acuity adequate to perform job duties, including visual examination of patient (if applicable) and reading information from printed sources and computer screens.
• Other: Adequate physical ability includes sufficient manual dexterity to perform the requisite job duties.

Work Environment

• Work environment is typical of an office setting.
• Work may be fast-paced and intense at times.
• Interaction with others is constant and interruptions may occur.
• Schedule requires flexibility to occasionally include evenings, early mornings, and weekends.