Precertification Team Lead - Patient Access & Compliance

Medical University of South Carolina; Charleston, Northern (SC, KY); Hybrid; USD 39,000 - 55,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Employer Sponsored Retirement Plan

Paid Time Off

Parental Leave

Disability insurance

Tuition Reimbursement

Employee discounts

Flexible schedule options

Certification incentive program

Job summary

MUSC Community Physicians (MCP) is seeking a Precertification Specialist Team Lead to oversee the preauthorization unit, ensuring timely, accurate, and compliant authorizations. This leader will mentor staff, coordinate workflows, and serve as SME for payer guidelines and medical necessity, acting as liaison among staff, providers, and payers to support patient access and revenue integrity.

The role emphasizes leadership, coaching, and cross-functional collaboration to maintain efficient

Qualifications

• Leadership of precertification staff and operations.
• Knowledge of payer requirements and medical necessity guidelines.
• Experience with authorization processes and EHR documentation.

Responsibilities

• Lead and mentor precertification staff to meet productivity and quality targets.
• Prioritize workloads based on urgency and payer requirements; escalate complex cases.
• Review and oversee high-risk authorization requests; ensure compliance with policies.
• Coordinate with clinical teams to obtain complete documentation; monitor statuses.

Skills

Team Leadership

Staff Development

Precertification

Payer Requirements

Documentation in EHR

Job description

MUSC Community Physicians (MCP) is seeking a Precertification Specialist Team Lead to oversee the preauthorization unit, ensuring timely, accurate, and compliant authorizations. This leader will mentor staff, coordinate workflows, and serve as SME for payer guidelines and medical necessity, acting as liaison among staff, providers, and payers to support patient access and revenue integrity.

The role emphasizes leadership, coaching, and cross-functional collaboration to maintain efficient