Healthcare Team Leader

4 days ago

Pasay, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱900,000 - ₱1,200,000 per year

We are seeking an experienced and results-driven Healthcare BPO Team Lead with prior authorization experience to join our team. As a Team Lead, you will be responsible for overseeing a team of associates who handle prior authorization processes. Your leadership will ensure that the team meets performance goals, delivers high-quality service, and adheres to industry standards and regulations.

Key Responsibilities:

  • Team Leadership:

  • Lead, mentor, and motivate a team of BPO associates working on prior authorization tasks.

  • Monitor and assess team performance to ensure accuracy, compliance, and productivity.
  • Provide guidance and support to team members in resolving issues and handling complex prior authorization cases.
  • Conduct regular team meetings and provide feedback to help improve team performance.

  • Prior Authorization Management:

  • Oversee the day-to-day operations of prior authorization requests and approvals.

  • Ensure timely and accurate submission of prior authorization requests in line with healthcare regulations and company protocols.
  • Collaborate with healthcare providers, insurance companies, and clients to ensure smooth processing of requests.
  • Troubleshoot and resolve escalated issues related to prior authorization delays or denials.

  • Process Improvement & Compliance:

  • Identify opportunities for process improvements and implement best practices for efficiency and effectiveness.

  • Ensure compliance with HIPAA regulations and other industry standards.
  • Stay up-to-date with changes in healthcare regulations related to prior authorization and implement necessary updates within the team.

  • Reporting & Documentation:

  • Maintain accurate records of prior authorization requests, decisions, and outcomes.

  • Prepare and present performance reports to senior management, highlighting achievements, challenges, and solutions.
Requirements:
  • At least 1 year experience as a Team Leader
  • At least 2 years experience in Healthcare BPO preferably in Prior Authorization role
  • Strong knowledge in Healthcare terminologies and RCM
  • Strong knowledge of prior authorization processes, including insurance protocols, medical coding, and billing.
  • Experience working with healthcare providers, insurance companies, and third-party administrators
  • Amenable to report onsite at Pasay

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