RN Prior Authorization Lead

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RN Prior Authorization Lead

Job Description

The Prior Authorization Lead oversees the daily operations of the Prior Authorization team by coordinating workflow, monitoring productivity, providing staff training, resolving complex authorization issues, and serving as the subject matter expert for payer requirements. This position partners with clinic leadership, providers, revenue cycle departments, and payers to ensure authorizations are obtained accurately and timely, minimizing delays in patient care and reducing authorization-related denials.

Hours: Full-time/ 40 hours per week

Required: ADN; RN

Pay: based off experience, starting at $30.56

Responsibilities

Assist with onboarding, training, mentoring and ongoing education of staff., Collaborate with Revenue Cycle departments to reduce authorization-related claim denials., Develop and maintain standardized authorization workflows and reference materials., Escalate urgent or complex authorization issues to leadership and providers as needed., Identify trends impacting reimbursement and develop corrective action plans., Perform quality audits and provide feedback to staff., Promote a collaborative, patient-centered team environment., Provide day to day leadership and guidance to the Prior Authorization Team., Stay current on payer policy changes and communicate updates to the team.

Requirements

ADN (Required)RN-Registered Nurse - Illinois Department of Financial and Professional Regulation

Compensation

Estimated Compensation Range

$30.56 - $47.37

Pay based on experience