Precertification & Authorization Manager

Job description

Position Summary: The Precertification & Authorization Manager is responsible for leading the daily operations of the surgical precertification team, including oversight of local staff and offshore vendors. This leader will ensure timely and accurate verification of insurance benefits, prior authorizations, and pre-surgical financial clearance to support over 3,000 monthly surgical cases. A hands-on, solutions-driven leadership style is essential to navigating complex payer requirements, collaborating with physicians, and delivering exceptional patient and provider experiences. Key Responsibilities: - Lead and manage the Surgical Precertification team, including three on-site Coordinators and two offshore vendor teams - Ensure all surgical cases are authorized at least 30 days prior to the scheduled procedure to avoid OR delays - Oversee insurance eligibility checks, benefit verifications, prior authorizations, and patient financial pre-collections - Serve as the escalation point for complex or high-priority cases, working closely with local staff and vendors to resolve - Track productivity, error rates, turnaround times, and ensure accountability across internal and third-party st...