Order Processing Supervisor

Altivera Medical; United States; On-site; USD 65,000 - 90,000; Full time

Job summary

Altivera Medical seeks a Supervisor to oversee Order Documentation Specialists, ensuring accurate, timely reviews of medical records and claims. You will lead team coaching, enforce payer criteria, and drive workflow efficiency while upholding privacy standards.

You will mentor staff, monitor quality metrics, and coordinate with cross-functional teams to resolve escalations and improve processes in a fast-paced healthcare environment.

Qualifications

• Minimum of five years reviewing and interpreting medical records, claims documentation, or related healthcare docs.
• Minimum of three years supervisory, training, quality review, or workflow oversight in US healthcare.
• Strong ability to coach team members and provide clear feedback.

Responsibilities

• Supervise daily activities of Order Documentation Specialists reviewing medical records and claims.
• Assign and balance workload to meet timelines and accuracy targets.
• Provide coaching and day-to-day support on documentation review standards and payer requirements.
• Review escalated cases and provide guidance on incomplete or unclear documentation.
• Monitor quality, productivity, timeliness, and accuracy; identify trends and gaps.
• Conduct quality reviews and calibration discussions to ensure consistent payer criteria usage.
• Ensure documentation outcomes are recorded accurately in designated systems.
• Collaborate with internal teams to resolve issues and improve handoffs across processes.
• Maintain confidentiality per privacy requirements and company policies.
• Support onboarding, training, and updates related to payer rules and documentation standards.
• Escalate recurring issues and propose process improvements.
• Participate in department planning, audits, and reporting.

Skills

Team Leadership

Coaching

Documentation Review

Payer Requirements

Quality Management

Communication & Escalation

Process & Compliance

Workflow Management

Education

High School Diploma

Associate Degree or healthcare coursework

Tools

Microsoft Office

EMR systems

Payer portals / claims platforms

Job description

Description

This role oversees daily workflow, productivity, quality, training, coaching, and escalation support to ensure documentation reviews are completed accurately, consistently, and timely. The Supervisor serves as a subject matter expert for documentation review standards, payer requirements, internal workflows, and quality expectations while supporting continuous improvement, team development, and compliance with established guidelines, standard operating procedures, and privacy requirements.

Job Details

This role oversees daily workflow, productivity, quality, training, coaching, and escalation support to ensure documentation reviews are completed accurately, consistently, and timely. The Supervisor serves as a subject matter expert for documentation review standards, payer requirements, internal workflows, and quality expectations while supporting continuous improvement, team development, and compliance with established guidelines, standard operating procedures, and privacy requirements.

Core Competencies

• Team Leadership & Coaching - Leads, supports, coaches, and develops Order Documentation Specialists to promote consistent performance, accountability, and professional growth.
• Documentation Review Expertise - Provides guidance on medical records, claims documentation, and supporting clinical information in a non-clinical capacity.
• Payer Criteria & Medical Necessity Oversight - Ensures the team applies established insurance medical necessity criteria, payer requirements, internal review standards, and workflow instructions consistently.
• Quality Management - Monitors documentation accuracy, identifies trends, provides feedback, and supports corrective action when quality expectations are not met.
• Communication & Escalation - Communicates clearly with specialists, internal teams, leadership, and cross-functional partners regarding documentation findings, escalations, process changes, and performance expectations.
• Process & Compliance Discipline - Reinforces adherence to established criteria, checklists, standard operating procedures, privacy requirements, and escalation pathways.
• Workflow & Productivity Management - Manages team workload, monitors productivity, removes barriers, and ensures timely completion of documentation review activities.

Essential Duties & Responsibilities

• Supervise the daily activities of Order Documentation Specialists responsible for reviewing medical records, claims documentation, payer criteria, and related support materials.
• Assign, monitor, and balance team workload to ensure documentation reviews, authorizations, follow-ups, and related tasks are completed accurately and within established timelines.
• Provide coaching, training, feedback, and day-to-day support to specialists regarding documentation review standards, payer requirements, workflow expectations, and system usage.
• Review escalated cases and provide guidance when documentation is incomplete, inconsistent, unclear, or requires additional review before next steps are taken.
• Monitor team quality, productivity, timeliness, and accuracy metrics; identify trends, performance gaps, and opportunities for improvement.
• Conduct quality reviews, calibration discussions, and performance follow-up to promote consistent application of payer criteria, internal review standards, and documentation expectations.
• Ensure documentation review outcomes are recorded accurately and consistently in designated systems, trackers, or case management tools.
• Partner with internal teams to resolve documentation issues, clarify requirements, support authorization follow-up, and improve handoffs across the order and claims process.
• Maintain confidentiality of patient, provider, and claims information in accordance with company policies and applicable privacy standards, and ensure team adherence to those expectations.
• Support onboarding, training, refresher education, and process updates related to payer rules, documentation standards, internal procedures, and compliance requirements.
• Escalate recurring issues, workflow barriers, payer changes, or documentation trends to leadership with recommended actions or process improvements.
• Participate in department planning, workflow improvement initiatives, audit preparation, reporting, and other supervisory or administrative duties as assigned.

Qualifications

Required

• High school diploma or equivalent required; associate degree or relevant healthcare coursework preferred.
• Minimum of five years of experience reviewing and interpreting medical records, claims documentation, clinical documentation, insurance documentation, prior authorization records, or related healthcare documentation.
• Minimum of three years of experience in supervisory, training, quality review, or workflow oversight required in the US Healthcare space.
• Working knowledge of medical terminology and the ability to understand documentation related to patient history, diagnoses, treatment plans, orders, and supporting clinical notes.
• Strong ability to coach team members, explain documentation expectations, and provide clear feedback in a professional and constructive manner.
• Strong attention to detail and ability to identify documentation gaps, inconsistencies, discrepancies, quality trends, and process improvement opportunities.
• Excellent written and verbal communication skills, including the ability to summarize findings, communicate expectations, and escalation issues clearly and professionally.
• Ability to interpret and reinforce established criteria, checklists, standard procedures, payer requirements, and leadership direction.
• Proficiency with Microsoft Office applications and the ability to use claims, documentation, authorization, reporting, or case management systems.
• Ability to manage competing priorities, team workload, escalations, and performance expectations in a fast-paced environment.

Preferred

• Experience supervising or leading a documentation review, prior authorization, utilization review support, durable medical equipment, home health, specialty pharmacy, claims, or healthcare operations team.
• Experience conducting quality reviews, performance coaching, team training, workflow audits, or calibration sessions.
• Experience using electronic medical record systems, payer portals, claims platforms, document management tools, productivity trackers, or reporting dashboards.
• Familiarity with payer guidelines, coverage policies, audit documentation, medical review workflows, and healthcare compliance requirements.