The Team Lead will oversee daily operations for intake, authorization, and scheduling functions while providing leadership and coaching to team members. They are responsible for monitoring performance metrics, ensuring compliance with payer requirements, and driving process improvements to enhance revenue cycle efficiency.
Responsibilities
Team Leadership and Daily Operations
Provide day-to-day leadership and direction to team members supporting Intake, Authorization, and Scheduling functions.
Coordinate daily workloads, assignments, priorities, and coverage to ensure operational requirements and service expectations are met.
Serve as the first point of escalation for workflow questions, complex cases, payer issues, patient access concerns, and other operational challenges.
Monitor team productivity, quality, attendance, responsiveness, and adherence to established processes.
Conduct regular team meetings, individual coaching sessions, and performance discussions.
Support onboarding and training of new team members and provide ongoing education as workflows, payer requirements, and client expectations change.
Identify performance gaps and provide appropriate coaching, retraining, and escalation to management when necessary.
Promote accountability, collaboration, and consistent execution across the team.
Intake and Patient Access Oversight
Oversee intake and referral workflows to ensure patient demographic, insurance, referral, and required documentation is collected accurately and timely.
Ensure eligibility and benefits verification is completed appropriately before services are provided.
Monitor incomplete referrals and outstanding intake requirements and ensure appropriate follow-up occurs.
Support escalation of complex eligibility, coverage, referral, and patient access issues.
Ensure team members accurately identify and route prior authorization requirements during the intake process.
Authorization and Payer Management Oversight
Oversee prior authorization workflows, including eligibility verification, authorization submission, tracking, renewals, concurrent reviews, denial follow-up, and appeals.
Ensure authorization requests are complete, accurate, and submitted within applicable payer timelines.
Monitor pending and expiring authorizations and ensure appropriate follow-up occurs before services or authorized limits are impacted.
Support team members with complex payer requirements, authorization issues, denials, and escalations.
Monitor authorization-related denial trends and work with operational leadership to identify opportunities for process improvement.
Ensure accurate documentation of authorization numbers, approved services, effective dates, expiration dates, visit limits, and other payer requirements.
Ensure scheduling activity appropriately considers provider availability, service requirements, patient needs, and authorization status.
Monitor provider utilization and open appointment capacity and work with the team to minimize unfilled appointment slots.
Ensure pending, expired, or incomplete authorizations are identified before affected services are scheduled.
Support escalation of scheduling issues that may affect patient access, provider utilization, reimbursement, or continuity of care.
Monitor scheduling trends and work with operational leadership to address capacity constraints and recurring workflow issues.
Performance, Quality and Reporting
Monitor team performance against established productivity, quality, accuracy, turnaround time, and service-level expectations.
Track and report key operational metrics across Intake, Authorization, and Scheduling functions.
Review work for accuracy and compliance and participate in quality assurance activities.
Identify trends, workflow gaps, recurring payer issues, and performance concerns and recommend corrective actions.
Assist management with reporting, workload forecasting, staffing needs, and resource allocation.
Maintain accurate documentation of team performance, coaching, training, and operational issues.
Support process improvement initiatives designed to improve patient access, authorization performance, scheduling efficiency, reimbursement readiness, and overall revenue cycle performance.
Required Qualifications
Minimum of 3 years of healthcare Revenue Cycle Management experience, with experience in patient access, intake, insurance verification, prior authorization, scheduling, or related front-end RCM functions.
Prior RCM experience supporting behavioral health services is required.
Previous experience as a Team Lead, Senior Specialist, Supervisor, or similar role with responsibility for providing day-to-day direction to multiple team members.
Strong understanding of insurance eligibility and benefits, prior authorization, payer requirements, patient access, scheduling, and their relationship to reimbursement.
Experience working with commercial and managed care payers.
Experience using payer portals such as Availity, NaviNet, and payer-specific platforms.
Experience with EHR, practice management, scheduling, or other healthcare revenue cycle systems.
Demonstrated ability to monitor productivity, quality, workload, and operational performance.
Strong coaching, communication, organizational, and problem-solving skills.
Ability to manage multiple priorities and operational workflows in a high-volume environment.
Working knowledge of HIPAA and healthcare privacy and confidentiality requirements.
Bilingual English/Spanish communication skills preferred.
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