Prior Authorization Team Lead

Our Clients; Philippines; In loco; PHP 420.000 - 700.000; Tempo pieno

Descrizione del lavoro

Confidential Hiring is seeking an experienced Patient Access Lead/Supervisor to oversee daily operations, ensuring efficient insurance verification, benefits review, and authorization support within a patient-centered care setting. The role involves coaching a team, monitoring performance, and maintaining compliance with payer requirements.

The onsite position in Bridgetowne, Quezon City offers a mid-shift schedule and opportunities for development within a healthcare-focused Patient Access team.

Competenze

• High School Diploma or equivalent required; Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field is preferred.
• 3-5 years of experience in Patient Access, Insurance Verification, Benefits, Referrals, Authorizations, Revenue Cycle, physician office, or hospital environments.
• 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.

Mansioni

• 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.

Conoscenze

Leadership

Communication

Organizational

Analytical

Problem-solving

Coaching

Conflict-resolution

Formazione

Associate's or Bachelor's in Healthcare Administration or related field

High School Diploma or equivalent

Strumenti

EHR systems

Eligibility tools

Pre-certification platforms

Payer portals

Microsoft Office

Reporting tools

Descrizione del lavoro

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