Operations Supervisor (Prior Authorization - US Healthcare account)

Cardinal Health

  • Taguig City, Metro Manila
  • Permanent
  • Full-time
  • 8 days ago
What Customer Service Operations contributes to Cardinal HealthCustomer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution.Customer Service Operations is responsible for providing outsourced services to customers relating to medical billing, medical reimbursement, and/or other services by acting as a liaison in problem-solving, research and problem/dispute resolution.Job SummaryThe Insurance Verification Supervisor assists the Insurance Verification Manager in overseeing the insurance verification process, ensuring efficient and accurate verification of patient insurance coverage and authorizations. They provide direct supervision to a team of insurance verification specialists, supporting their development and ensuring adherence to established procedures and standards.ResponsibilitiesSupervises and support a team of insurance verification specialists.Provides training, coaching, and mentorship to team members to enhance their skills and performance.Fosters a collaborative and positive work environment conducive to achieving team goals.Assists in the development and implementation of standardized procedures for insurance verification.Oversees and participates in the verification of patient insurance coverage, ensuring accuracy and timeliness.Supports team members in resolving insurance-related inquiries and discrepancies.Assists in coordinating the authorization process for medical procedures and services requiring pre-authorization.Communicates with insurance companies to obtain authorizations and resolve authorization-related issues.Monitors authorization status and escalate issues as necessary to ensure timely approvals.Collaborates with billing and coding teams to address insurance-related claim rejections and denials.Assists in investigating and resolving discrepancies in insurance coverage and billing information.Provides guidance to team members on optimizing claim submission and reimbursement processes.Conducts regular training sessions and provide ongoing support to ensure team members are proficient in insurance verification procedures and software.Identifies training needs and opportunities for professional development among team members.Encourages continuous learning and skill enhancement within the team.Assists in ensuring compliance with HIPAA regulations and other relevant healthcare laws and regulationsConducts periodic audits of insurance verification processes to ensure accuracy and compliance.Collaborates with the Insurance Verification Manager to implement improvements and address areas for enhancementEmbraces and exemplifies the Cardinal Health values:
Invites Curiosity, Builds Partnerships, Inspires Commitment, Develops Self and OthersOther Responsibilities- May perform any additional responsibilities or special projects as required.- May provide cross-functional support as business needs demand.
- Duties and responsibilities may be subject to change based upon the needs of the department.QualificationsInternal
(1) No Disciplinary actions for the past 12 months(2) At least 1 year of tenure in current role(3) Knowledge in Healthcare Operations specifically Prior AuthorizationExternal
(1) At least 2 years of college coursework or experience(2) 2 years of Leadership experience(3) Knowledge in Healthcare Operations specifically Prior Authorization is required(4) Experience in using Contact Center phone system such as NICE and/or Genesys is an advantageExpected Competencies
- Professional, and effective communications skills; able to calmly present solutions in challenging situations.· Proactive identification of challenges, and solution-oriented approach to problem solving.· Service-orientation and aptitude to utilize proper listening skills.· Effective analytical skills: able to use inductive and deductive reasoning to anticipate outcomes.· Self-directed accountability and reliability· Effective leadership, communication, and interpersonal skills, with the ability to influence and collaborate effectively with cross-functional teams.· Able to manage and prioritize multiple tasks/projects, work autonomously, and meet deadlines.· Able to work well in a team environment that promotes inclusiveness and communication among team members.· Communication using both verbal and written English proficiency.Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.To read and review this privacy notice click

Cardinal Health