Healthcare Access Lead – Pre-Cert & Scheduling

PM Consulting; Philippines; On-site; PHP 800,000 - 1,400,000; Full time

Job summary

PM Consulting is seeking a Healthcare Lead to oversee day-to-day pre-certification, prior authorization, scheduling, and patient access functions. You will ensure timely, accurate, and compliant processing of healthcare services while supporting appointment readiness and reducing delays and denials.

You will guide a team, monitor performance, and collaborate with clinical teams, providers, payers, and leadership to maintain efficient workflows.

Qualifications

• Minimum 3–5 years of healthcare experience in relevant functions.
• At least 2 years of leadership, team lead, supervisory, or workflow coordination experience.
• Strong knowledge of CPT, ICD-10, medical terminology, EHR systems, payer portals, and authorization platforms.

Responsibilities

• Oversee daily pre-certification, prior authorization, and scheduling workflows.
• Monitor team productivity, quality, turnaround times, accuracy, and service levels.
• Provide coaching, guidance, and performance support to team members.
• Handle escalated authorization, payer, scheduling, and patient access issues.
• Ensure accurate documentation of authorization and scheduling activities in EHR and related systems.
• Coordinate with clinical teams, providers, payers, and front-end staff to prevent delays and cancellations.
• Ensure compliance with payer requirements, medical necessity guidelines, and organizational policies.
• Maintain and improve SOPs, workflows, and operational guidelines.
• Identify process gaps and implement improvements to reduce delays, rework, and denials.
• Support staffing, workload allocation, training, and team performance activities.
• Prepare operational reports and communicate performance updates to leadership.
• Support implementation, transition, and process improvement initiatives.

Skills

Healthcare experience

Leadership experience

CPT & ICD-10 knowledge

Education

Bachelor’s degree in Healthcare Management, Business Administration, Nursing, or related field preferred

Job description

PM Consulting is seeking a Healthcare Lead to oversee day-to-day pre-certification, prior authorization, scheduling, and patient access functions. You will ensure timely, accurate, and compliant processing of healthcare services while supporting appointment readiness and reducing delays and denials.

You will guide a team, monitor performance, and collaborate with clinical teams, providers, payers, and leadership to maintain efficient workflows.