Authorizations Team Lead

Bone & Joint; Town of Wausau (WI); Presencial; USD 60.000 - 78.000; Tempo integral

Resumo da vaga

Bone & Joint seeks a Prior Authorizations Team Lead to guide surgical, clinic, and physical therapy authorization operations. You will ensure accurate, timely, and compliant authorizations that protect revenue and keep patient care on track.

The role requires leadership, strong knowledge of payer rules, coding accuracy, and the ability to mentor staff while collaborating with Coding, Billing, and Clinical teams. Occasional travel to multiple Bone & Joint locations is expected.

Qualificações

• Understand payer rules and medical necessity requirements.
• Experience in managing authorizations, billing, coding, or revenue cycle.
• Proven leadership or mentorship experience.
• Strong communication and organizational skills.

Responsabilidades

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

Conhecimentos

Payer rules knowledge

Medical necessity expertise

Analytical reporting & trend analysis

Leadership / mentoring

Communication & organization

Problem solving

Formação

High school diploma or equivalent

Associate degree preferred

Ferramentas

Microsoft Office

PM/EHR systems

Descrição da vaga

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.