Supervisor, Physician Authorization/Referral
The Physician Referral Authorization Department Supervisor has extensive authorization knowledge. The Supervisor can handle complex referrals/authorizations and issues for any physician/office-based services, including in office procedures/testing, cardiology, and audiology. The authorization responsibility extends to high dollar Pharmacy, Pathology, offsite physician authorizations/Partner Hospital registration and charge release.
The Supervisor will do the following:
-Provide direct support and supervise the department’s Authorization Specialists, and Lead Authorization Specialists. The Supervisor will monitor assigned work queues to ensure cases are worked timely and other required information is satisfied.
-Deploy staff to work appropriate specialties as needed to even the workload and to ensure proper coverage. Monthly audits, financial estimate creation, and performance management goals are created and monitored. Goal results will be shared with associates.
-Identify areas of improvement. The supervisor will ensure that all department policies are communicated to and followed by associates.
Work closely with Managed Care, Provider Enrollment; payers, clinic specialties, physicians, Financial Services, Central Business office; Access Management Team and Hospital Preauthorization Department. The Supervisor will communicate with partner hospitals for offsite patient enrollment, registration and charge release.
-Cover all referral/authorization types, participate in organizational committees/task forces, attend payor meetings, and demonstrate effective utilization of EPIC applications as indicated by performance measures. This position will also assist with new and existing associate training.
The Physician Referral Authorization Department Supervisor provides continuous quality improvement by monitoring/adjusting workflows, identifying opportunities, suggesting improvements, and initiating implementation of new services to authorize. The Supervisor position serves as the role model for others and a system/process expert. The Supervisor will handle the onboarding and offboarding processes. The Supervisor acts as a change agent who encourages alternative approaches and new ideas.
Qualifications:
| Current CRCR ( Certified Revenue Cycle Representative) |
| More than 5 years authorization experience required. Lead, Sr, or Supervisor experience required. Advanced office based authorizations/ referrals for procedures and testing experience required. Extensive knowledge of physician authorizations/ referrals. |
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