Prior Authorization Team Lead (Part-Time)

Enhanced Revenue Solutions, Inc., now part of Infinx Healthcare, is currently hiring for a part-time Prior Authorization Specialist. Come join our team and be a part of an amazing team!

Schedule: Monday-Friday 4:00pm-8:00pm

Summary Description:
Under general direction, this position will be responsible to help track the daily work activities that are performed by the prior authorization (PA) team as well as ensure that all facility accounts are current each month. They will also be responsible for pulling monthly charges and working with finance to invoice the respective clients. The PA Team Lead is also responsible for aiding the departmental manager as well as assisting other managers and program staff regarding precertification’s, authorizations and other AR functions. They will manage the completion and maintenance of all precertification/authorization related activities and documents. This position is responsible for overall monitoring, reporting and accountability of the prior authorization task.

Daily Responsibilities

  • Help the departmental manager to provide quality control of facility referral, precertification’s and authorization.
  • Identify potential issues and opportunities with recommending result solutions and have the ability to recognize when a problem needs to be escalated to the Manager.
  • Ability to interact with other departments in a professional manner.
  • Help ensure that the teams are obtain timely prior authorization/ prior- determination/ or prior – certification from all insurances, that require based upon plan or insurance contract, following the company established policies and protocols.
  • Provide coverage for fellow teammates when they are out of the office.
  • Needs to have the ability to be flexible with your work schedule if it is necessary to meet deadlines or deliverables as assigned by the manager and Executive Management.
  • Experience with prior authorization/ prior- determination/ or prior – certification from all insurance plans.
  • Understand payer polices and procedures as it relates to precertification requirements.
  • Works with internal and external teams to ensure cases are processed timely.
  • Must meet/exceed daily/weekly production KPI’s.

Skills and Education:

  • Knowledge of latest technologies pertinent to the ERS discipline.
  • Knowledge of industry trends pertinent to the ERS discipline.
  • Knowledge of depth experience and exposure to the healthcare provider industry and demonstrate knowledge of hospital operations and systems.
  • Experience with payer plan polices and guidelines.
  • Proficient in Microsoft Office products, with intermediate level of Excel and understanding of pivot tables required.
  • Ability to problem solve and work independently and pay close attention to detail.
  • Strong interpersonal and communication skills and the ability to work effectively in a diverse environment on a high level. Customer service experience required.
  • Ability to adapt, organize, prioritize and manage various work assignments in a fast paced environment.
  • 1+ years within an BPO / Service environment.
  • Meet department productivity standards.
  • Consistently reports to work on time and prepared to perform duties of position.
  • Communicate regularly with management about department issues or process improvement initiatives.
  • Knowledge and understanding of business principles, processes and technology.
  • Excellent communication skills (written and verbal) and strong organizational skills.
  • Strong organizational skills; attention to detail and good group presentation skills.
  • Experience in proven client interaction skills with a focus on account management, business development.
  • Proficient in business communication – written and oral and excellent documentation skills.
  • High proficiency in MS office suite, specifically excel and PowerPoint.
  • Associate degree in related field or five years’ experience in a supervisory role.

Job Type: Part-time
Pay: $20.00 – $22.00 per hour

To apply, email your resume to hr@enhancedrevenuesolutions.com.

About the Author

Avatar