Prior Authorization Unit Supervisor
Prior Authorization Unit Supervisor
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Salary Not Disclosed
1 Vacancy
Job Description
This a Philippine-based position;
NOT a US based position and the pay rate is not in US currency.
ABOUT FREEDOM HEALTH SYSTEMS INC:
Freedom Health Systems Inc. is a mission-driven healthcare advisory and management consulting firm that partners with behavioral health and human services organizations to improve access equity and operational excellence. We specialize in guiding providers through program development accreditation compliance and clinical best practicesempowering them to deliver high-quality person-centered care to their communities.
While we do not provide direct healthcare services Freedom Health Systems plays a vital role behind the scenes by strengthening organizational infrastructure supporting service expansion and helping our partners lead with innovation and integrity. Our expertise spans a wide range of operational services including revenue cycle management prior authorization virtual front office support medical billing and coding human resources and compliance consulting.
At Freedom Health Systems we are deeply committed to breaking down barriers in the behavioral health space with a particular focus on serving marginalized and underserved populations. Our team fosters a collaborative forward-thinking work environment where every employee contributes to advancing impactful community-based care.
DISCLOSURES:
The specific statements shown in each section of this job description are not intended to be all-inclusive. They represent typical elements and criteria considered necessary to perform the job successfully. The jobs responsibilities/tasks may be modified and/or expanded over time. Company will inform the personnel member when changes in the respective job description are made.
COMPANY PHONE NUMBER:
HUMAN RESOURCES DEPARTMENT PHONE NUMBER: EXT 10
HUMAN RESOURCES DEPARTMENT EMAIL ADDRESS:
POSITION TITLE: Prior Authorization Unit Supervisor
ALTERNATE TITLE(S): PA Manager Authorization & Intake Manager
COMPANY: Freedom Health Systems Inc. (in support of all customer companies under contract)
DIVISION: Accounting & Finance
DEPARTMENT: Accounts Receivables
UNIT: Prior Authorization
BENEFITS PACKAGE: Ineligible.
WORK SCHEDULE: Monday Friday 8:00 AM EST 5:00 PM EST
ACCOUNTABLE TO: Accounts Receivables Department Manager (Controller in the absence of the Accounts Receivables Department Manager)
ACCOUNTABLE FOR: Managing prior authorization and initial intake processes for medical behavioral health and support services across all affiliates
CLASSIFICATION: W8BEN
COMPENSATION RANGE: 482.16 PHP per hour (this is not USD)
ANTICIPATED TRAVEL: none
SUMMARY OF POSITION RESPONSIBILITIES:
The Prior Authorization Manager oversees the end-to-end authorization workflow ensuring that service requests submitted to Medicaid Medicare and commercial payers meet the criteria for approval and are processed within required timelines. This role supervises a team of Prior Authorization Associates and collaborates with clinical and billing departments to ensure documentation accuracy compliance and reimbursement alignment.
This position is supervised by the Accounts Receivables Department Manager and plays a critical role in supporting clean claims and timely payment. The Prior Authorization Manager is also responsible for ensuring that all clients receiving medical or behavioral health services are fully prior authorized at least three (3) business days prior to the scheduled service date.
The manager ensures that pre-authorization requirements are met for behavioral health primary care housing-related supports and other specialty services. They are also responsible for managing intake triage authorization submissions appeals coordination and payer correspondence.
SCHEDULED DUTIES AND RESPONSIBILITIES:
- Supervise daily operations of the prior authorization and intake team
- Maintain updated knowledge of payer-specific authorization requirements and clinical documentation standards
- Review and approve initial and continuing authorizations for submission
- Collaborate with providers case managers and clinical documentation teams to obtain and verify required records
- Ensure all requests are submitted accurately and within deadlines to avoid care delays or denied claims
- Guarantee that all medical and behavioral health clients are authorized no later than three business days prior to service
- Monitor and manage team productivity metrics (e.g. turnaround time approval rates rework rate)
- Develop internal workflows and SOPs to standardize intake and authorization processing
- Train and cross-train team members on systems policy changes and payer updates
- Coordinate appeal and reconsideration submissions for denied authorizations
- Maintain accurate and auditable logs of authorizations expiration dates and renewal status
- Serve as liaison between the billing department and clinical teams to ensure pre-authorization alignment with reimbursement expectations
- Provide weekly reporting to the Director of Operations on authorization volume turnaround times and outcomes
UNSCHEDULED DUTIES AND RESPONSIBILITIES:
- Assist your supervisor with any work-related tasks as requested taking initiative where possible
- Remain informed and compliant with regulations and standards including COMAR CARF and other relevant governing bodies as well as company policies and procedures
- Support the maintenance of a safe work environment by participating in drills and safety trainings as requested
- Maintain confidentiality of all records especially those relating to client treatment or financial information
- Participate in external and internal audits/surveys (CARF/CSA/OHCQ) as directed by the supervisor
- Contribute to quality assurance and performance improvement plans by conducting audits and activities that ensure regulatory compliance
- Participate in audit preparation and respond to payer or licensing inquiries as needed
- Support onboarding of new programs by identifying payer authorization requirements
- Collaborate with quality assurance and compliance teams to address trends and implement process improvements
- Assist with coverage or overflow of authorization tasks during high-volume periods
- Attend clinical operations or cross-departmental meetings to stay aligned with service delivery goals
PHYSICAL DEMANDS:
- Prolonged periods sitting at a desk and working on a computer
- Frequent meetings via video or phone; occasional in-person site visits
WORKING CONDITIONS:
- Remote
- Fast-paced deadline-driven environment with collaborative teams
COMPETENCIES AND SKILLS:
- Strong knowledge of prior authorization procedures across Medicaid Medicare and commercial payers
- Attention to detail and document accuracy
- Team supervision and training skills
- Excellent communication and collaboration with clinical and administrative departments
- Strong time management and prioritization abilities
- Proficiency with EHR systems and payer portals
LEVEL OF EDUCATION / TRAINING / QUALIFICATIONS:
- Associate or Bachelors degree in Health Administration Nursing or related field (required)
- Minimum 3 years of experience in prior authorization with at least 1 year in a supervisory or team lead capacity
- Familiarity with behavioral health and Medicaid service models preferred
- Experience with managed care plans appeals processes and payer documentation standards
- Ability to pass background and reference checks
Required Experience:
Manager
Employment Type
Contract
