Prior Authorization Team Lead

Create Synergies Inc.; Philippines; On-site; PHP 893,000 - 1,339,000; Full time

Benefits offered by this job

Onsite work in Bridgetown, Quezon City

Mid-shift schedule

Job summary

Confidential Hiring in Bridgetown, Quezon City is seeking a Patient Access Lead/Supervisor to oversee daily operations of the Account Specialist team under Patient Access – Benefits & Authorization. The role focuses on ensuring accurate verifications, authorizations, and benefit interpretations within a mid-shift, onsite setting.

You will supervise performance, coach staff, and collaborate with multiple departments to optimize workflows and patient financial responsibility processes.

Qualifications

• High School Diploma or equivalent required; Associate's or Bachelor's degree preferred in Healthcare Administration or related field.
• 3–5 years experience in Patient Access, Insurance Verification, Benefits, Referrals, Authorizations, Revenue Cycle in healthcare settings.
• ≥1 year in a lead/supervisory/training/quality review role preferred.
• Strong knowledge of insurance verification, benefit interpretation, prior authorization, and payer requirements.
• Familiarity with CPT, ICD-10, clinical terminology, and payer medical necessity guidelines.
• Proficiency with EHR systems, eligibility tools, pre-certification platforms, payer portals, Microsoft Office, and reporting tools.
• Excellent leadership, communication, organizational, analytical, problem-solving, coaching, and conflict-resolution skills.
• Ability to manage workloads, analyze trends, identify root causes, and implement workflow improvements.
• Orthopedic experience strongly preferred.

Responsibilities

• Supervise daily operations in insurance verification, benefits review, and authorization support.
• Monitor team productivity, quality, turnaround times, and service levels.
• Serve as SME on payer requirements, eligibility, referrals, authorizations, and network participation.
• Review team documentation for accuracy and compliance with standards.
• Provide coaching, training, feedback, and performance development to team members.
• Handle escalated inquiries from patients, providers, payers, and internal teams.
• Collaborate with Front Office, Clinical, Revenue Cycle, and leadership to resolve issues and improve workflows.
• Support staffing coordination, workload balancing, and quality assurance initiatives.
• Prepare and communicate operational and performance reports to leadership.
• Ensure compliance with policies, privacy standards, and regulations.

Skills

Leadership

Communication

Organization

Analytical thinking

Problem-solving

Coaching

Conflict resolution

Workload management

Education

High School Diploma

Associate's degree in Healthcare Administration or related

Bachelor's degree in Healthcare Administration or related

Tools

EHR systems

Eligibility tools

Pre-certification platforms

Payer portals

Microsoft Office

Reporting tools

Job description

Job Description:

PATIENT ACCESS - LEAD / SUPERVISOR

Company: Confidential Hiring

Location: Bridgetowne, Quezon City

Work Setup: Onsite

Schedule: Mid Shift

We are looking for an experienced Patient Account Specialist Supervisor to oversee the daily operations, performance, quality, and development of the Account Specialist team under Patient Access – Benefits & Authorization.

Key Responsibilities:

• Supervise daily operations involving insurance verification, benefits review, package registration, referrals, authorization support, and patient financial responsibility workflows.


• Monitor team productivity, quality, turnaround times, and service levels.


• Serve as a subject matter expert on payer requirements, eligibility tools, benefit interpretation, referrals, authorizations, network status, and provider participation.


• Review team documentation to ensure accuracy and compliance with established standards.


• Provide coaching, training, feedback, and performance development to team members.


• Handle escalated patient, provider, payer, and internal inquiries.


• Collaborate with Front Office, Clinical, Contact Center, Revenue Cycle, and leadership teams to resolve issues and improve workflows.


• Support staffing coordination, workload balancing, process improvement, and quality assurance initiatives.


• Prepare and communicate operational and performance reports to leadership.


• Ensure compliance with departmental policies, payer requirements, privacy standards, and applicable regulations.

Qualifications:

• High School Diploma or equivalent required; Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field is preferred.


• At least 3–5 years of experience in Patient Access, Insurance Verification, Benefits, Referrals, Authorizations, Revenue Cycle, physician office, or hospital environments.


• At least 1 year of experience in a lead, supervisory, training, quality review, or workflow coordination capacity is preferred.


• Strong knowledge of insurance verification, benefit interpretation, prior authorization, referral processes, payer requirements, and patient financial responsibility.


• Familiarity with CPT, ICD-10, medical terminology, clinical documentation, and payer medical necessity guidelines.


• Proficiency in EHR systems, eligibility tools, pre-certification platforms, payer portals, Microsoft Office, and reporting tools.


• Strong leadership, communication, organizational, analytical, problem-solving, coaching, and conflict-resolution skills.


• Ability to manage workloads, analyze trends, identify root causes, and implement workflow improvements.


• Orthopedic experience is strongly preferred.

What We Offer:

• Onsite work environment in Bridgetowne, Quezon City


• Mid-shift schedule


• Opportunity to lead and develop a healthcare-focused Patient Access team


• Career growth and professional development opportunities

Requirements: