Precertification Leader—Healthcare Authorization

Methodist Le Bonheur Healthcare; Memphis (TN); On-site; USD 70,000 - 95,000; Full time

Job summary

Methodist Le Bonheur Healthcare in Memphis seeks an experienced supervisor for the Authorization Specialists. You will oversee precertification of diagnostic and outpatient services, ensure compliant documentation, and guide the department in line with MLH values.

The role emphasizes leadership, policy interpretation, and collaboration with payers and physicians to optimize reimbursement and patient care outcomes.

Qualifications

• Technical Degree or Diploma in Nursing required.
• Licensed Practical Nurse – Tennessee license required.
• 5–7 years in authorization/denials management and clinical nursing.
• Experience with precertification and CPT codes highly preferred.

Responsibilities

• Supervise day-to-day operations of the pre-certification department.
• Provide guidance and direction to staff and department.
• Precertify eligible medical services and procedures.
• Ensure documentation meets insurer medical necessity and payment guidelines.
• Coordinate with physicians, staff, and payers to maximize reimbursements.
• Monitor department productivity and staffing levels.

Skills

Leadership

Policy interpretation

Analytical ability

Communication

Supervisory skills

Staffing planning

Education

Technical Degree or Diploma Nursing

Licensed Practical Nurse (TN)

Tools

Microsoft Office

Insurance pre-certification knowledge

CPT codes

Job description

Methodist Le Bonheur Healthcare in Memphis seeks an experienced supervisor for the Authorization Specialists. You will oversee precertification of diagnostic and outpatient services, ensure compliant documentation, and guide the department in line with MLH values.

The role emphasizes leadership, policy interpretation, and collaboration with payers and physicians to optimize reimbursement and patient care outcomes.