Initial Authorization Manager

PROMPTCARE COMPANIES INC•King of Prussia, PA

3d•Hybrid

About The Position

PromptCare is seeking a highly motivated and experienced Initial Authorization Manager to join our team. The ideal candidate will have a strong background in healthcare, particularly healthcare insurance guidelines along with strong team management skills. The position will entail the management of the Initial Authorization staff documentation compliance and payer related issues impacting the ability to obtain Initial Authorizations. The manager will work collectively with Intake and Resupply management and staff to ensure authorization requirements are fulfilled.

Requirements

Bachelor’s degree preferred or comparable equivalent and related experience
Previous experience in DME is required
Medical reimbursement knowledge is required
Prior experience managing or overseeing staff is required
Appropriate computer skills for the position (Microsoft Office Suite) and areas of influence; Brightree experience is required
Strong work ethic and the desire to lead by example, with attention to detail and quality
Ability to deal directly with staff on policy or performance-related issues
Excellent oral and written communication skills required to communicate with colleagues, management, customers, and insurance plan representatives

Responsibilities

Ensure all initial tasks are worked and completed timely, ensuring accuracy with payer requirements including procedure codes, diagnosis, quantity limitation, initial start dates and required documentation.
Suggest, implement and update any changes in policy, fee schedule and other payer limitations via Brightree or internal process according to existing payer guidelines.
Stay current on payer policy updates along with coverage criteria.
Ensure all payer portals are accessible to staff. Remain proficient in portal use within the team.
Provide regular reporting to Senior Management by monitoring productivity and metric measurement along with other KPI’s as needed. Communicate regular feedback to staff on process, compliance and other related performance measurements.
Identify recurring denial patterns and implement corrective action alongside appeals process to reduce bad debt.
Be an active participant in education and development of staff.

Benefits

Comprehensive Medical, Dental, and Vision Package
401(k) Plan with Company Match
Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays
Life Insurance: Standard coverage with optional enhancements
Employee Assistance Program: Free counseling and coaching sessions
Emotional Well-being and Work-Life Balance Resources
Short & Long-Term Disability: Company-paid with optional supplements
Accidental Death and Dismemberment Insurance
FSA and HSA: Manage healthcare expenses
Commuter Spending Programs
Volunteer and Engagement Opportunities
Employee Referral Bonuses
Exclusive Discounts on entertainment, travel and various other supplemental and cellphone plans