Supervisor, Prior Authorizations

This is a Fully Remote Job About Our Client: The organization operates within the healthcare revenue cycle management sector, focusing on optimizing billing operations related to prior authorizations. It addresses challenges in managing prior authorization workflows, payer requirements, and reimbursement processes to reduce delays and improve compliance. The company supports both domestic and offshore teams, emphasizing operational oversight and process improvements to enhance efficiency in authorization management. About the Opportunity: The SUPERVISOR, PRIOR AUTHORIZATION is responsible for overseeing the daily operations and performance of multiple teams within the Prior Authorization function. This role ensures accurate and timely resolution of authorization issues, manages team productivity and quality, and drives improvements in workflows that support compliance and minimize reimbursement delays. The supervisor serves as a key liaison between internal and external stakeholders to resolve escalated cases and optimize operational efficiency. Responsibilities: Manage daily operations of Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams. Provide leadership, coaching, and performance management for domestic and offshore team members. Monitor team metrics such as productivity, turnaround times, and quality. Oversee resolution of prior authorization denials and coordinate appeals. Identify and resolve authorization discrepancies affecting claim processing. Monitor workload distribution and follow-up on outstanding cases. Act as escalation point for complex authorization and payer issues. Collaborate with Billing, Insurance Verification, Denials & Appeals, and other teams to improve workflows. Align offshore teams with performance expectations and procedures. Analyze denial trends and implement process improvements. Ensure compliance with payer requirements, policies, and healthcare regulations. Conduct quality reviews and audits of authorization processes. Prepare and communicate operational performance reports. Support development of workflows, training materials, and SOPs. Participate in hiring, onboarding, training, and performance evaluations. Foster a collaborative and improvement-focused team environment. Requirements: Associate's or Bachelor's degree in Healthcare Administration, Business, Finance, or related field, or equivalent experience. Minimum 3 years healthcare revenue cycle experience, including prior authorization and related processes. At least 1 year in a supervisory or leadership role. Strong knowledge of prior authorization workflows, payer policies, denials, and appeals. Understanding of commercial and government payer policies and medical necessity requirements. Experience monitoring KPIs and implementing process improvements. Strong analytical, organizational, and problem-solving skills. Excellent communication and interpersonal abilities. Ability to manage priorities and lead teams in a fast-paced environment. Pay Range and Compensation Package: The pay range and compensation package for this role will be determined based on the candidate's experience, skills, and other relevant factors. Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note: TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.