Prior Authorization Manager

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🌟 Join the One GI Family as Our Next RCM Benefits & Prior Authorizations Superstar!

Are you the kind of person who loves turning organized chaos into smooth operations? At One GI, we’re on the lookout for a dynamic leader to take charge of our RCM Benefits and Prior Authorizations team. You’ll be the mastermind keeping the day-to-day running like a well-oiled machine — overseeing operations, reports, and records, all while empowering your team to shine.
Reporting to our Director of RCM, this role isn’t just about managing processes — it’s about making an impact. If you’ve got a passion for leadership, a knack for coordination, and a drive to make healthcare better, we can’t wait to meet you!
Ready to join the team? Apply today and let’s do great work together!

• Excellent paid time off for a healthy work/life balance.
• We’ve got your future in mind! With our generous 401(k) plan, we’ll help you grow your nest egg with an employer match that makes saving for retirement even sweeter.
• Looking to further your education? We want to help! We offer education reimbursement opportunities, with generous annual support based on your employment status.
• Internal growth opportunities. We want to aide in your training and development.
• Competitive health and supplemental benefits; with FSA and HSA options.
• Love where you work? Spread the word! Refer a friend who’d be a great fit for One GI® and earn a special bonus when they join the team!

• Coordinate and oversee administrative and operational efforts for the RCM Benefits & Prior Authorizations team.
• Ensure teams have the necessary tools and training to perform the functions to support appropriate clinical abstraction from patients’ records and interpretation of insurance payer medical policies for obtaining authorizations and generating accurate patient estimates.
• Establish and recommend policies and procedures for improvement.
• Analyze reports to achieve department goals and objectives and provide remediation to staff.
• Prepare reports and analysis noting progress as well as adverse trends.
• Provide assistance regarding patient accounts including resolution of coding/billing inquiries.
• Maintain current knowledge of governmental, legal and regulatory provisions related to medical billing, practice management and collection activity.
• Oversee front of the revenue cycle including eligibility, prior authorization, and upfront patient estimations and collections.
• Manage user roles and access for various payor websites and portals.
• Liaison to insurance companies, Medicare, other third-party payors, outside facilities and vendors for all relevant matters.
• Review CPT and ICD-10 updates and communicate changes to staff.
• Take an active role in self-development and train as appropriate.

• High School Diploma or equivalent required.
• Bachelor’s degree or equivalent experience required.
• Progressive experience within a business office/practice in the healthcare field required.
• Five (5) years experience in management and multi-facility oversight role required.
• Ability to travel approximately 25% of the year required.

Seniority level:
Mid-Senior level

Employment type:

Other
Job function:
Human Resources
Industries:
Hospitals and Health Care

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