Supervisor of Pre-Authorization & Referrals

Altru Health System•Grand Forks, ND

9d•Onsite

About The Position

The Supervisor Pre-Authorization & Referrals is responsible for the daily operations, oversight, and performance of the Pre-Authorization and Referral team. This role ensures timely and accurate insurance authorization, referral processing, and compliance with payer requirements to support patient access, continuity of care, and revenue cycle integrity. The supervisor provides leadership, coaching, and development for staff while promoting exceptional customer service and operational excellence.

Requirements

Associates - Business/Finance/Healthcare- OR -Associates - Related Field
A minimum of 3 years Related Experience
Proficiency in reading, writing, and speaking English to ensure effective communication in the workplace and with patients, families, and team members.

Nice To Haves

Bachelors - Business/Finance/Healthcare- OR -Bachelors - Related Field
HFMA Membership within 1 month of start date

Responsibilities

Supervises pre-authorization and referral staff, including hiring, onboarding, training, scheduling, coaching, performance management, and staff meetings.
Fosters a culture of accountability, collaboration, patient-centered service, and continuous improvement.
Develops and maintain staffing plans to ensure adequate coverage, balanced workloads, and achievement of productivity, quality, and service expectations.
Oversees the timely and accurate processing of insurance authorizations, prior authorizations, and specialty referrals in accordance with payer requirements, medical necessity guidelines, and organizational policies.
Monitors work queues, workflows, and performance metrics to optimize turnaround times, address performance concerns, and improve operational efficiency.
Identifies process gaps and implement improvements to enhance efficiency, accuracy, patient experience, and overall service delivery.
Collaborates with clinical departments, providers, scheduling, revenue cycle teams, and payer representatives to resolve authorization and referral issues and address escalated concerns.
Monitors denials, appeals, delays, and related trends; develop action plans and support revenue cycle initiatives to reduce financial risk, improve reimbursement, and minimize avoidable write-offs.
Performs other duties as assigned or needed to meet the needs of the department/organization.