Centralized Authorization Manager
CurrentResponsible for oversite of accurately obtaining service authorizations in a timely and efficient manner with a high level of accuracy on a consistent basis.SIGNIFICANT DUTIES· Serves as a chief retention and safety officer and ensures that safety and quality standards are upheld or met by effective use of data and technology to make decisions and proactively mitigate unnecessary risk by means of verification of insurance coverage, timely follow-up of claims processing, and monthly statistics.· Oversee a department of 30 agents, develop and implement workflows to ensure best practices to identify KPI’s for efficiency. This is executed by means of routine quality analysis on employee output and workflow processes.· Communicate with payors, patients, and providers to obtain necessary information and resolve challenges related to coverage, CPT/ICD-10 use, and valid location of service.· Monitor volume metrics and right sizing workflow to encourage company daily productivity standards currently set at minimum 100 touchpoints per day.· Lead routine meetings and provide consistent feedback to director and executive leadership with a focus on challenges, opportunities, and efficiency points.· Monitor and maintain a collaborative relationship between associates, leadership, and providers.· Escalate opportunities and challenges to all ancillary departments for planning, decision-making, and problem solving.· Develop rules of engagement to systematically resolve income losses, and improve input processes to reduce denial events.