Lead Insurance & Prior Authorization Manager

USA Vein Clinics, Vascular, Fibroid and Oncology Centers; Northbrook (IL); On-site; USD 70,000 - 85,000; Full time

Benefits offered by this job

Health

Dental

Vision

PTO

401k

Job summary

USA Clinics Group is seeking an Insurance and Prior Authorization Manager to lead a team that supports physicians and the revenue cycle. You will oversee documentation, authorization and eligibility processes, driving efficiency and accuracy in a fast-paced outpatient setting.

Responsibilities include monitoring team performance, coaching staff, coordinating with IT for automation, and collaborating with billing on denials related to authorization.

Qualifications

• High school diploma or equivalent required.
• Bachelor's degree in health information administration preferred.
• 3 years medical authorization experience required.
• Strong background in Revenue Cycle Management preferred.
• Active knowledge of CMS guidelines, contracted insurance guidelines and coding policies.
• Ability to lead a team with positive attitude and effective communication.

Responsibilities

• Monitor productivity and performance of the team and report to Senior Leadership.
• Provide frequent feedback and foster two-way communication with staff.
• Coach employees and implement action plans for improvement.
• Oversee prior authorization and eligibility automation processes.
• Assist IT in developing automation for authorization submission and insurance verification.
• Collaborate with billing to address claim denials related to authorization and eligibility.
• Produce reports on productivity and errors to identify improvement opportunities.
• Prioritize work to maximize turnaround time.
• Coordinate with insurance plans for eligibility and coverage information.
• Obtain prior authorization for services as needed.
• Document findings thoroughly and accurately.
• Train staff on requesting, documenting, and processing prior authorizations.

Skills

Leadership

Communication

CMS guidelines

Coding policies

Revenue Cycle Management

Prior Authorization

Education

Bachelor's degree in health information administration

High school diploma or equivalent

Job description

USA Clinics Group is seeking an Insurance and Prior Authorization Manager to lead a team that supports physicians and the revenue cycle. You will oversee documentation, authorization and eligibility processes, driving efficiency and accuracy in a fast-paced outpatient setting.

Responsibilities include monitoring team performance, coaching staff, coordinating with IT for automation, and collaborating with billing on denials related to authorization.