Referral & Authorization Lead, Medical Services

White-Wilson Medical Center, PA; Fort Walton Beach, Northern (FL, KY); On-site; USD 55,000 - 75,000; Full time

Job summary

White-Wilson Medical Center, P.A. in Fort Walton Beach, FL is seeking a Referral and Authorization Team Lead to oversee the authorization process for medical services, confirm insurance coverage, and ensure timely submissions.

You will lead a team of specialists, develop SOPs, monitor KPIs, and coordinate with providers, payers, and patients to resolve authorization and referral issues. This is a full-time, on-site role with regular attendance.

Qualifications

• Two years’ experience in a medical office.
• Certified Medical Assistant or Nursing certification strongly preferred.
• Typing and office procedures experience as part of education or training.
• Pre-certification experience strongly preferred.

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 issues related to authorizations and referrals.
• Assign tasks and ensure team productivity.
• Ensure compliance with 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 escalate when necessary.
• Create and revise training materials and SOPs for the team.
• Track KPIs and report team performance to management.
• Analyze authorization trends to identify areas for improvement.
• Perform related duties as required.
• Regular and reliable attendance required.

Skills

Team leadership

Communication

Typing

Office procedures

Education

High School Diploma or GED

CMA or Nursing certification (preferred)

Job description

White-Wilson Medical Center, P.A. in Fort Walton Beach, FL is seeking a Referral and Authorization Team Lead to oversee the authorization process for medical services, confirm insurance coverage, and ensure timely submissions.

You will lead a team of specialists, develop SOPs, monitor KPIs, and coordinate with providers, payers, and patients to resolve authorization and referral issues. This is a full-time, on-site role with regular attendance.