Authorizations Team Lead

Bone & Joint; Town of Wausau (WI); On-site; USD 60,000 - 90,000; Full time

Job summary

Bone & Joint is seeking a Prior Authorizations Team Lead to guide a cross-disciplinary group protecting revenue and patient care. You will oversee surgical, PT, and clinic authorizations, ensuring accuracy, compliance, and timely submission.

You bring 2+ years in authorizations or revenue cycle, plus coding knowledge or certification, and a leadership mindset. Expect onsite leadership with occasional travel and strong collaboration with Coding, Billing, and Clinical teams.

Qualifications

• Knowledge of payer rules and medical necessity.
• Experience with prior authorizations, billing, coding, or revenue cycle.
• Leadership or mentorship experience.
• Analytical mindset with reporting and trend analysis.
• Proficiency with Microsoft Office and PM/EHR systems.
• Valid WI driver's license.

Responsibilities

• Guide and support the Prior Authorizations team in processing surgical, PT, and clinic authorizations.
• Ensure authorizations are accurate, compliant, and submitted timely.
• Stay on top of payer rules, CPT/HCPCS codes, and medical necessity guidelines.
• Monitor turnaround times, trends, and bottlenecks.
• Identify process improvements that reduce denials and optimize revenue.
• Collaborate with Coding, Billing, and Clinical teams to support clean documentation.
• Train, mentor, and onboard new and existing staff.
• Support hiring, evaluations, and workflow optimization.
• Serve as backup when the Supervisor is out of office.
• Travel to Bone & Joint locations as needed for onsite leadership.

Skills

Payer rules & medical necessity

Leadership / mentorship

Trend analysis & reporting

Communication & problem-solving

PM/EHR systems

Microsoft Office

Driver's license

Education

High school diploma

Associate degree preferred

Tools

Microsoft Office

PM/EHR systems

Job description

Lead a high‑impact team that keeps patient care moving forward.

Are you a detail‑driven problem solver with strong knowledge of payer rules, coding, and medical necessity? Do you love improving processes, guiding teams, and making healthcare operations run smoothly? If so, this is the role for you!

Bone & Joint is seeking a Prior Authorizations Team Lead to support and elevate our surgical, clinic, and physical therapy authorization operations. This role is essential to ensuring accurate, timely, and compliant authorizations that protect revenue and keep patient care on track.

What You'll Do

As our Authorizations Team Lead, you will:

• Guide and support the Prior Authorizations team in processing surgical, PT, and clinic authorizations
• Ensure authorizations are accurate, compliant, and submitted timely
• Stay on top of payer rules, CPT/HCPCS codes, and medical necessity guidelines
• Monitor turnaround times, trends, and potential bottlenecks
• Identify process improvements that reduce denials and optimize revenue
• Collaborate with Coding, Billing, and Clinical teams to support clean documentation
• Train, mentor, and onboard new and existing staff
• Support hiring, evaluations, and workflow optimization
• Serve as backup when the Supervisor is out of office
• Travel to Bone & Joint locations as needed for onsite leadership

What You Bring

• High school diploma required; associate degree preferred
• 2+ years' experience in prior authorizations, billing, coding, or revenue cycle
• Coding certification (CPC, COC, etc.) preferred
• Strong understanding of payer rules & medical necessity
• Analytical mindset with experience in reporting & trend analysis
• Proven leadership or mentorship experience
• Excellent communication, organization, and problem‑solving skills
• Proficiency with Microsoft Office and PM/EHR systems
• Valid WI driver's license

Why Join Us?

At Bone & Joint, you'll lead a team that plays a critical role in supporting patient care and revenue integrity. We offer a collaborative environment, professional growth, and the chance to make a real impact every day.