Insurance Authorization Manager

$70,000 - $75,000/Yr

Aspen Infusion - Chandler, AZ

Full-time - Mid Level

Chandler, AZ

About the position

The Insurance Authorization Manager at Aspen Infusion is responsible for overseeing a team that secures prior authorizations from insurance companies for medical services. This role ensures timely approvals by coordinating with patients, healthcare providers, and insurance carriers while adhering to compliance regulations. The manager optimizes revenue cycle management by monitoring authorization processes and addressing any potential issues with coverage or denials.

Responsibilities

• Lead and supervise a team of insurance authorization specialists.
• Assign tasks, monitor performance, and provide coaching to ensure accurate and efficient authorization processes.
• Conduct staff training on insurance guidelines, medical coding, and authorization procedures.
• Oversee staffing, scheduling, and task assignment to ensure proper coverage and efficient workflow.
• Conduct performance reviews, identify areas for improvement, and foster a culture of continuous improvement, accountability, and teamwork.
• Communicate effectively with patients, healthcare providers, billing staff, and insurance companies to gather necessary information and address concerns regarding authorizations.
• Review patient medical records and insurance benefits to determine required authorizations for upcoming procedures or treatments.
• Initiate and follow up on prior authorization requests with insurance companies via phone, fax, or electronic systems.
• Monitor pending authorization requests and escalate any potential delays or denials to appropriate parties.
• Generate reports on authorization metrics such as approval rates, denial rates, and turnaround times to identify trends and areas for improvement.
• Analyze data to identify potential issues with insurance coverage or billing practices and propose solutions.
• Recruit, hire, and direct customer service department staff members.
• Arrange for performance evaluation of each member of the customer service department staff annually; establish annual performance goals, and monitor progress toward these goals.
• Coordinate with the Revenue Cycle Management team regarding appropriate authorization and accurate claim submission.
• Ensure adherence to all state and federal regulations regarding patient privacy and insurance billing practices.
• Regularly audit authorization processes to identify areas for improvement and maintain compliance with payer guidelines.

Requirements

• 2-year college degree is preferred but not required.
• 3-5 years related supervisory experience and/or training, or equivalent combination of education and experience.
• Strong communication skills.
• Technically proficient in platforms such as Google Suite (Docs, Forms, Sheets), Gmail, Paylocity, RingCentral/Glip, and Caretend experience is a plus.
• Ability to organize and plan the activities of subordinates, and to delegate appropriately.
• Organizational skills sufficient to maintain consistently accurate records.
• Experience in Customer Service and leadership roles.
• Ability to evaluate options and to make efficient decisions.

Nice-to-haves

• Experience with EMR systems such as Caretend.
• Knowledge of medical coding and insurance guidelines.

Benefits

• Competitive salary between $70,000 - $75,000 per year.
• Opportunities for professional development and training.