Prior Authorization Team Lead De La Pena Eye Clinic Commerce

Prior Authorization Team Lead

The Prior Authorization Team Lead is actively involved in assisting the Patient Communication Manager with problem solving and conflict resolution with team members, customers, and insurance companies. Under the direct supervision of the Patient Communication Manager this position requires assisting with a high level of timely, accurate, and complete analysis and oversight of the prior authorizations department from the insurance companies, facility programs and the patients, as well as the protection from loss of revenue. The Prior Authorization Team Lead is responsible for working co-operatively in a team setting, promoting team spirit and generating ideas that will develop the team and the Practice. The employee will adhere to and comply with the Covenant Code of Conduct, Human Resource Policies and Procedures, Operational Policy and Procedure Manual, Patient Bill of Rights, HIPAA compliance, and Corporate Compliance Plan.

Responsibilities

Assist with organizing and assigning daily workflow within the team.

Read and evaluate authorization reports and identify trends.

Ensure compliance of all rules and regulations of insurance carriers.

Ensure all authorizations are processed timely and accurately.

Work closely with the Patient Communication Manager to ensure timely authorization requests and approvals.

Identify and create solutions to problems relating to the timely processing of prior authorizations.

Monitor authorizations request for accurate insurance coding and timely processing.

Respond to patient account inquiries, questions, and complaints when necessary.

Qualifications

EDUCATION AND / OR EXPERIENCE

High School Diploma or equivalent.

5 years of successful prior authorization experience.

Experience with practice management systems and clearinghouses; G-Med experience preferred.

About Us

Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Tenet Physician Resources, we are seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.

At Tenet Physician Resources, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include :

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note : Eligibility for benefits may vary by location and is determined by employment status

About the Team

Tenet Physician Resources (TPR) provides the ability for physicians to focus on what matters most - compassionate care to the communities we serve - while we manage the day-to-day operations. TPR offers a wide range of opportunities for professionals to meet career expectations at every stage of life. Practices employ physicians, medical assistants and administrative staff to work in environments with advanced medical equipment, robust data and technology.