Authorization Supervisor

Position Summary:
Responsible for planning, organizing, and supervising the daily operations of the Authorization Department. The Authorization Supervisor is responsible for the accurate and timely processing of all authorization to ensure no service or reimbursement disruption. The position confirms that authorizations are processed in a timely manner, ensuring health plan protocols are followed and that information is communicated and updated in EMR system. The supervisor must have a keen understanding of insurance concepts, and health plan policies. The supervisor will ensure that staff is aware of current health plan policies, requirements and is trained in all system requirements. The Supervisor will be responsible for coaching, mentoring, and developing of team members to achieve a high-performance standard.
Qualifications:
Education:

• High school diploma or equivalent
• Associate degree in medical or business is preferred

Experience

• Minimum three (3) years previous medical benefits and/or authorization experience.
• Previous supervisory/leadership experience preferred.
• Extensive knowledge of patient registration and authorization processes required.
• General knowledge of CPT, HCPCS and ICD-10-CM coding assignments and their applications to the authorization process.

Licensure/Certification/Registration

• Active certification in any of programs identified below required.
  • Certified Health Access Associate (CHAA) or
  • Certified Health Access Management (CHAM) or
  • Certified Revenue Cycle Associate (CRCA) or
  • Certified Coding Associate (CCA) or
  • Certified Professional Coder (CPC) or
  • Registered Health Information Technician (RHIT) or
  • Registered Health Information Management (RHIA)

Duties & Responsibilities:

• Responsible for obtaining insurance authorizations, verifying benefits and eligibility for surgical, radiology, and rehabilitative services in an efficient and timely manner.
• Review and monitor modality schedules to ensure that proper and accurate authorizations have been received prior the patient's scheduled visit.
• Works in conjunction with Scheduling departments to reschedule/cancel visits when a change in authorization occurs.
• Achieves staff results by communicating job expectations, planning, monitoring, and appraising job results; coaching, counseling and enforcing systems, policies, procedures, and productivity standards
• Responsible for tracking and organizing status of authorizations and ensuring supporting documentation is part of patient medical record.
• Conduct management duties including arranging staff schedules, provide and/or arrange for staff training, performing coaching sessions with staff,
• Maintain department productivity and ensure compliance with policies and procedures.
• Provide oversight to day-to-day operations
• Keeps up to date with current authorization and referral regulations and compliance requirements.
• Troubleshooting patient/provide complaints, develops process improvements to prevent recurrences.
• Interact with leadership and partners through attending meetings and process improvement initiatives.
• Recommend and assist in the development of policies and procedures to improve workflows, efficiencies, and to meet and exceed goals/metrics set for the department.
• Responsible for conducting performance evaluations, coordinating staff schedules, and evaluating patient flow to maintain maximum productivity and efficiency.
• Greet all patients and their accompanying family members when applicable and provide exemplary customer service.
• Work effectively and collaboratively with colleagues, physicians, and department heads.
• Effectively utilize strong organizational skills.
• Consistently display effective verbal communication skills.
• Proficient understanding and use of technology/PC skills required.
• Regularly exercise independent judgment.