Mgr, Revenue Cycle-Prior Authorization - Remote
Job Summary:
Effectively leads the Prior Authorization functional area within billing, collection or accounts receivable management, maintaining a full understanding of the billing information system. Manages the activities of staff through daily supervision while overseeing designated functional area across revenue cycle including but not limited to billing and pre-certification. Assists with implementing strategic goals by deploying internal and external staff.
Job Responsibilities:
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Experience with Managing large teams, including supervision of staff of a pre-certification department.
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Experience with directing self and others in areas of responsibility such as research, appeals, order entry, pre-certification and eligibility.
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Assists with feedback for hiring, discipline and performance evaluations.
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Provides department orientation and ongoing training for all in/direct reports.
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Liaison with internal departments to promote ongoing communication, and collaboration on cross functional projects related to prior authorization.
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Analyzes prior authorization outcomes from all sources, including carrier reimbursement exception reporting and follow up pending prior authorization analysis and denials management.
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Represent organizational projects and assist management with follow-through and implementation of initiatives.
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Manage all aspects of the prior authorization department including the timely, accurate submission and collection of all patient and customer accounts.
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Works with across departments to manage the entire process from insurance verification to final collection.
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Responsible for the timely accurate submission of all prior authorizations for service to the responsible payer.
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Ensure that all payers needing prior authorization are set up correctly within the software system.
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Monitors and validates adherence to Policies and Procedures, auditing as necessary. Monitors and evaluates employee productivity and performance to goal.
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Builds employee morale, motivation and loyalty by fostering positive working relationships.
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This role works with PHI on a regular basis both in paper and electronic form and have …
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Benefits/Perks401k benefits Commuter benefits Competitive Competitive benefits Comprehensive medical Dental Employee Referral Program Fertility care benefits Free testing Life and disability plans Pregnancy and baby bonding leave Vision
SkillsAccounts Receivable Management Appeals Billing Coding Collection Communication Compliance Compliance regulations Denials Management Eligibility Excel Genetics Healthcare policy Insurance verification Microsoft Office Oncology Order Entry Payer eligibility Policies and procedures Pre-certification Prior authorization Reimbursement Research Sales Supervision Training
Tasks- Analysis
- Analyze prior authorization outcomes
- Denials Management
- Department orientation and ongoing training
- Directing self and others
- Liaison with internal departments
- Manage all aspects of the prior authorization department
- Prior Authorization Analysis
- Represent organizational projects
- Supervision of staff
5 years
EducationAccountancy Bachelor's degree Business Business Administration Computer sciences Genetics Marketing Oncology Related Field Sales