Supervisor of Pre-Authorization & Referrals

Everything we do is underscored by a why and that why is one another.

Location:

Altru Health System PO Box 6002 Grand Forks ND 58201

Pay Range: $55078.40 - $82617.60

Summary:

The Supervisor Pre-Authorization & Referrals is responsible for the daily operations oversight and performance of the Pre-Authorization and Referral team. This role ensures timely and accurate insurance authorization referral processing and compliance with payer requirements to support patient access continuity of care and revenue cycle integrity. The supervisor provides leadership coaching and development for staff while promoting exceptional customer service and operational excellence.

Essential Job Functions:

• Supervises pre-authorization and referral staff including hiring onboarding training scheduling coaching performance management and staff meetings.
• Fosters a culture of accountability collaboration patient-centered service and continuous improvement.
• Develops and maintain staffing plans to ensure adequate coverage balanced workloads and achievement of productivity quality and service expectations.
• Oversees the timely and accurate processing of insurance authorizations prior authorizations and specialty referrals in accordance with payer requirements medical necessity guidelines and organizational policies.
• Monitors work queues workflows and performance metrics to optimize turnaround times address performance concerns and improve operational efficiency.
• Identifies process gaps and implement improvements to enhance efficiency accuracy patient experience and overall service delivery.
• Collaborates with clinical departments providers scheduling revenue cycle teams and payer representatives to resolve authorization and referral issues and address escalated concerns.
• Monitors denials appeals delays and related trends; develop action plans and support revenue cycle initiatives to reduce financial risk improve reimbursement and minimize avoidable write-offs.
• Performs other duties as assigned or needed to meet the needs of the department/organization.

• HFMA Membership within 1 month of start date

Education:

Required: Associates - Business/Finance/Healthcare- OR -Associates - Related FieldPreferred: Bachelors - Business/Finance/Healthcare- OR -Bachelors - Related Field

Work Experience:

Required: A minimum of 3 years Related Experience

Language Requirements:

This position requires proficiency in reading writing and speaking English to ensure effective communication in the workplace and with patients families and team members.

Physical Demands :

Sit: Frequently (34-66%)Stand: Occasionally (5-33%)Walk: Occasionally (5-33%)Stoop/Bend: Rarely (1-4%)Reach: Frequently (34-66%)Crawl: Not ApplicableSquat/Crouch/Kneel: Rarely (1-4%)Twist: Occasionally (5-33%)Handle/Finger/Feel: Continuously (67-100%)See: Continuously (67-100%)Hear: Continuously (67-100%)

Weight Demands:

Lift -Floor to Waist Level: Sedentary (<10 pounds)Carry: Sedentary (<10 pounds)Push/Pull: Sedentary (<10 pounds)Slide/Transfer: Not Applicable

Working Conditions:

Indoor: Continuously (67-100%)Outdoor: Not ApplicableExtreme Temperature: Not Applicable

Driving Requirement Definitions:

• Professional Drivers: Persons who drive as their main responsibility OR transport passengers or hazardous materials.
• Frequent Drivers: Persons whose main responsibility is not driving but drive daily or almost daily.
• Occasional Drivers: Persons who drive from once per month to as frequently as once per week.
• Infrequent Drivers: Persons who are generally not expected to drive.

Driving Requirement for this position:

Infrequent Driver

Reference ID: R8353

Making a real difference. For one another.

To take the best care of our patients and community including friends family and neighbors we need people who are committed to growth excellence and one another.

At Altru youll find a culture where support and teamwork are at the heart of what we do. Youll have opportunities to advance your skills work with the latest technologies experience the fulfillment that comes from giving back and take your career wherever you want it to go.

Join our team and be a part of a small community with a big heart.

Altru offers a comprehensive benefits package to its full- and part-time employees. Excellent benefits include a health plan and 401(k) retirement plan. Other benefits include a dental plan vision plan life and disability insurance education assistance paid time off (PTO)