Admissions & Prior Authorization Lead

Orsini; Elk Grove Village (IL); Hybrid; USD 60,000 - 65,000; Full time

Benefits offered by this job

Medical Coverage, Dental, and Vision

401(k) with employer match

Accident and Critical Illness coverage

Company-paid life insurance options

Generous PTO, holidays, and floatingH

Tuition reimbursement program

Job summary

Orsini in Elk Grove Village, IL, seeks a Supervising Prior Authorization team lead to oversee enrollments data-entry, oversee claims processing, and ensure HIPAA compliance. The role involves hiring, training, and motivating staff while maintaining accuracy and performance metrics.

The position requires leadership experience, a Pharmacy Technician License, and knowledge of pharmacy benefits and claims processing. It is a hybrid role with growth opportunities in a patient-focused organization.

Qualifications

• Leadership experience managing a team
• Experience with Major Medical Insurance
• Pharmacy Technician License – required
• National Technician Certification – preferred
• Knowledge of pharmacy benefit, rejection codes, and claims processing
• Knowledge of pharmacy and insurance terminology of coverage
• Knowledge of HCPCS codes
• Able to multitask in a fast-paced environment
• Detail-oriented
• Excellent verbal and written communication skills
• Ability to work with a diverse group of employees
• Ability to work collaboratively

Responsibilities

• Monitors production, volume, and quality of team output using reports and audits.
• Sets individual goals and provides performance feedback; handles HR issues per policy.
• Hires, trains, and motivates team; ensures tools and payroll for staff.
• Supports integration of new Specialty business for therapies handled by team.
• Resolves escalated Prior Authorizations and Specialty Benefits Verification issues.
• Develops policies/procedures and drives process improvements within the department.
• Performs other duties or projects as assigned.

Skills

Leadership

Major Medical Insurance

Pharmacy Benefit Knowledge

Rejection Codes

Claims Processing

HCPCS Codes

Multitasking

Detail-Oriented

Verbal & Written Communication

Collaborative Work

Diversity & Inclusion

Education

Pharmacy Technician License

National Technician Certification

Job description

Orsini in Elk Grove Village, IL, seeks a Supervising Prior Authorization team lead to oversee enrollments data-entry, oversee claims processing, and ensure HIPAA compliance. The role involves hiring, training, and motivating staff while maintaining accuracy and performance metrics.

The position requires leadership experience, a Pharmacy Technician License, and knowledge of pharmacy benefits and claims processing. It is a hybrid role with growth opportunities in a patient-focused organization.