Authorization and Insurance Specialist

Centria Healthcare•Farmington Hills, MI

7d•$17 - $20•Hybrid

About The Position

The Authorization and Insurance – Team Lead ensures that authorizations are submitted accurately, timely, and follow up to facilitate approval within payor standards. The Authorization and Insurance – Team Lead will also ensure all corresponding team members’ work is assigned and disseminated accordingly while serving as a point of escalation for team members. This role is responsible for leading and maintaining staff by orienting and training team members; ensuring the daily functions of the department are completed by communicating job expectations; planning, monitoring, and appraising job results; managing, coaching, and developing a high performing team that meets agreed objectives, and which delivers best practice results, added value, and continuous improvements; and consistently promoting high standards through personal example and roll out through the team so that each member of the team understands the standards and behaviors expected of them.

Requirements

High School Diploma or equivalent, minimum requirement
Relative Revenue Cycle Experience
Experience at the hiring manager’s discretion
Strong analytical skills
Customer Service and Phone Etiquette
Ability to follow written instructions
Ability to use computers and computer/software programs
Ability to communicate expressively and receptively
Proficient in Microsoft Office Suite (Word, Excel, and Access) and CareConnect
Requires strong quantitative and analytical skills, as well as verbal and written communication skills
Effective communication skills, both written and verbal with internal and external stakeholders
Ability to organize, prioritize, and handle multiple tasks; adhere to established deadlines; and produce work that consistently meets or exceeds team benchmarks
Results-driven with the aptitude to apply critical thinking skills and problem-solving
Proven adaptability with a willingness to work both collaboratively and individually to achieve desired business outcomes
Demonstrated strong work ethic with attention to detail, accuracy, and quality
Established track record of generating error-free work
Must be extremely organized and possess strong analytical and overall personnel management skills, as they will work closely with department managers
Additionally, they must have demonstrated leadership skills with the ability to communicate effectively with clients and co-workers.

Responsibilities

Process and procedure expert for assigned/applicable insurance policies.
Ability to step in and lead team huddles.
Ability to step in and lead direct reports in RCM Manager’s absence.
Audit/track accuracy of Insurance Verification, Eligibility and Authorizations – scope and frequency.
Knowledge of payor contracts in accordance with guidelines for Financial Clearance.
Coordinate with related internal staff on front-end “fails” identified.
Train new team members and assist in any coaching opportunities.
Work independently and collaborate in a team environment.
Assist in situations that require additional care and knowledge (new payor).
Ensure strict confidentiality of client records according to policy and procedures.
Make administrative and procedural decisions and judgments on sensitive, confidential issues.
Knowledge of computer data entry systems, protocols, and procedures.
Communicate effectively, both oral and written, to peers, team members, and payors/insurance companies.
Collaborate with RCM Billing/AR Teams in collection efforts from respective payors.
Collaborate with denial management team.
Other duties as assigned by the RCM Leadership Team.