Overview

Description:

Outpatient Authorization Team Lead

FLSA Status: Nonexempt

Report To: Authorization Manager

Supervises: Outpatient Authorization Specialists

Department: Care and Benefits Coordination

Summary

The Outpatient Authorization Team Lead will carry out normal Authorization Specialist duties as well as providing mentoring, coaching, and support to other Authorization Specialists.

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Provide mentoring, coaching, and support to Authorization Specialists, specifically Outpatient/Medical Services Team
  • Timecard and performance supervision
  • Assist CBC Management with performance conversations
  • Documents departmental processes, policies and procedures
  • Carries normal Authorization Specialist duties:
  • Obtain insurance verification and authorizations for active patients
  • Enter information and log calls accurately and timely on company EMR
  • Contact physician offices via fax and/or phone
  • Contact insurance offices via fax and/or phone to obtain authorization
  • Monitor all tasks using workflow software and company EMR and meet deadlines associated with the tasks
  • Develop a working relationship with insurance providers, physician offices and clinical staff at centers
  • Collaborate with internal departments to ensure that authorizations are received in an accurate and timely manner
  • Maintain confidentiality and adhere to all HIPAA and government guidelines and regulations
  • Perform other related duties as directed by management
  • Adhere to policies and procedures of Hopebridge
  • Assist in providing a safe environment for all staff
  • Assist with problem solving to improve efficiency and morale within the office
  • Portray a positive attitude and maintain a customer and co-worker satisfaction level that limits adverse situations or complaints
  • Promote Hopebridge philosophies, generating team spirit and creating and maintaining and environment that fosters staff satisfaction, maximizes productivity and profitability
  • Attend weekly meetings and training as requested
  • Maintain a clear criminal record
  • Other duties as assigned

. Requirements:

Competencies

  • Problem Solving/Analysis.
  • Communication proficiency
  • Ability to follow processes and procedures
  • Personal effectiveness/credibility
  • Problem solving
  • Customer service/client focus
  • Attitude towards others
  • Time management/organizational skills

Required Education and Experience

  • Must be at least 18 years of age
  • Possess a minimum of a high school diploma

Supervisory Responsibility

This position will be responsible for timecard and performance supervision.

Position Type/Expected Hours of Work

This is a full-time position, Monday through Friday. Occasional evening and weekend work may be required as job duties demand.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Physical Demands

This is a stationary position that requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability to adjust focus. It also may require occasional lifting, carrying, walking, climbing, kneeling, bending/stooping, twisting, pulling/pushing, walking, bending, stooping, and reaching above the shoulder. Employees in this position must be physically able to efficiently perform the essential functions of the position.

Work Environment:

Work is performed in an office environment. Work may be stressful at times due to a busy office. Interaction with others is constant and interruptive.

Disclaimer

The above statements reflect general functions of this job and shall not be construed as a detailed description of all work requirements inherent in this job. The immediate supervisor may elaborate on or add to the above list if the duties come within the employee’s realm of responsibility.

Hopebridge is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, sexual orientation, arrest record or any other characteristic protected by applicable federal, state or local laws.