Pre-Certification Specialist Lead

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Directs the Pre-Certification Specialist team, overseeing hiring, onboarding, scheduling, and performance evaluations.
• Maintains daily workflows to ensure timely and accurate patient access functions.
• Provides coaching and feedback to staff to maintain high standards of service and productivity.
• Trains staff in various areas such as check-in/out, chart auditing, call center, scheduling, insurance verification, and authorization submission.
• Maintains compliance with 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 excellent patient service by modeling and reinforcing positive behaviors, handling escalated patient concerns, and resolving issues promptly and professionally.
• Prepares and analyzes reports related to patient access performance metrics, ensuring compliance with organizational standards and payer requirements.
• Participates in departmental meetings and organizational initiatives, performs other related duties as assigned.

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. Prior supervisory or leadership experience preferred.
• Skills: Strong leadership and team-building skills, excellent communication and interpersonal abilities, proficiency in scheduling systems, insurance verification, and authorization processes, proficiency in using technology to optimize workflows, ensure data accuracy, and support efficient patient access operations, ability to manage multiple priorities in a fast-paced environment.

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. Job duties may require bending, reaching, repetitive hand movements, standing, walking, squatting, sitting and occasional heavy lifting, pushing and pulling.

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.