Centralized Authorization Lead

White-Wilson Medical Center,P.A.; Wright (FL); On-site; USD 60,000 - 85,000; Full time

Job summary

White-Wilson Medical Center, P.A. is seeking a Team Lead for the Referral and Authorization Team in Fort Walton Beach, FL. The role oversees the authorization process, leads a team of specialists, and ensures compliant, timely referrals with payers and providers.

The ideal candidate will have a medical office background (2+ years), preferred CMA or Nursing certification, and strong leadership and communication skills to drive process improvements and maintain high-quality patient care.

Qualifications

• Minimum of two years of experience in a medical office.
• CMA or Nursing certification strongly preferred.
• Strong communication and leadership skills required.

Responsibilities

• Oversee the referral and authorization process for medical services.
• Confirm patient insurance coverage and benefits.
• Ensure timely submission of authorization requests to payers.
• Lead and support a team of referral and authorization specialists.
• Monitor status of authorization requests and follow up as needed.
• Collaborate with providers, payers, and patients to resolve authorization/referral issues.
• Track team performance and report to management.
• Develop and revise SOPs and training materials for the team.

Skills

Leadership

Communication

Organizational skills

Problem solving

Education

High School Diploma or GED

Certified Medical Assistant or Nursing certification preferred

Job description

FORT WALTON BEACH, Ft Walton Bch, FL, US

24 days ago Requisition ID: 2252

Position Summary:

The Referral and Authorization Team Lead is responsible for overseeing the authorization process for medical services and treatments. This role ensures that all necessary approvals are obtained from insurance companies and other payers, facilitating smooth and timely patient care. The Team Lead will manage a team of specialists, ensuring compliance with all relevant regulations and policies, and will work closely with healthcare providers, payers, and patients to resolve any issues related to authorizations and referrals.

Essential Responsibilities:

• Oversee and manage the referral and authorization process for medical services.
• Confirm the patient's insurance coverage and benefits.
• Ensure timely and accurate submission of authorization requests to insurance companies and other payers.
• Lead and support a team of referral and authorization specialists.
• Monitor the status of authorization requests and follow up as necessary.
• Collaborate with healthcare providers, payers, and patients to resolve any issues related to authorizations and referrals.
• Assign tasks and ensure team productivity.
• Ensure compliance with all relevant regulations and organizational policies.
• Provide training and ongoing support to team members.
• Implement process improvements to enhance efficiency and accuracy in the authorization process.
• Address complex authorization issues and elevate when necessary.
• Create and revise training materials and standard operating procedures (SOPs) for the team.
• Track key performance indicators and report team performance to management.
• Analyze authorization trends to identify areas for improvement.
• Performs related duties as required.
• Regular and reliable attendance required.

Education/Experience:

• High School Diploma or GED equivalent with courses to include typing, business English and office procedures or completion of vocational training for medical office.
• Certified Medical Assistant or Nursing certification strongly preferred.
• Minimum of two years’ experience in a medical office.
• Pre-certification experience strongly preferred.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. Strong verbal and written communication skills required. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. Ability to exercise good judgment and handle multiple, simultaneous tasks effectively and efficiently while maintaining a professional, courteous manner. It must be detailed oriented and organized. Must be able to exercise good judgment and positively influence and lead others, including handling confrontations with poise and efficiency.

Position Type/Expected Hours of Work:

This is a full-time position. Days and hours of work are Monday through Friday between the hours of 8:00am-5:00pm.

Work Environment:

This position requires regular and reliable on-site attendance. Environmentally controlled medical environment. Fast paced environment with occasional high pressure or emergent situations.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

EEO Statement:

White-Wilson Medical Center, P.A. and affiliates are equal opportunity employers, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

full time Monday through Friday; on-site