Authorization Manager
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Job Description
Overseeing the Authorization department at PT Solutions to ensure timely and accurate processing of prior authorizations. Providing strategic leadership and managing workflows across various teams.
Responsibilities:
- Provide overall leadership and direction to the Authorization team, including Supervisors, Leads, and Specialists.
- Establish departmental goals, KPIs, and performance expectations to ensure operational excellence.
- Conduct coaching, performance evaluations, and corrective action as needed.
- Oversee daily operations to ensure timely and accurate processing of authorizations.
- Develop, maintain, and optimize workflows, SOPs, and training materials.
- Manage departmental KPIs, including turnaround time, accuracy, productivity, rollover rate, and denial impact.
- Partner with Scheduling, Verification, Billing, Clinic Operations, Compliance, and Payer Relations to align workflows and resolve issues.
Requirements:
- Bachelor’s degree in Healthcare Administration, Business, or related field preferred (or equivalent experience)
- Minimum 5 years of authorization, insurance verification, medical billing, or revenue cycle experience required
- Minimum 2–3 years of supervisory or management experience in a healthcare or revenue cycle environment
- Advanced knowledge of insurance authorization processes, medical necessity requirements, ICD-10, CPT, and payer guidelines
- Experience with EMR systems, payer portals, and analytics tools
- Strong financial and operational acumen, with experience managing department budgets and productivity standards
- Proven track record of driving performance, improving workflows, and developing high-performing teams.
Benefits:
- Professional development opportunities
- Ongoing evidence-based clinical education
- Dedicated mentorship opportunities
- APTA-accredited Orthopaedic Residency Program
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