Lead, Prior Authorization Specialist - Twin Cities Orthopedics

We are seeking a dedicated and experienced individual to join our team as a Rheumatology and Infusion Prior Authorization and Scheduling Specialist in a lead capacity. This role plays a critical part in ensuring timely and accurate coordination of prior authorizations and scheduling for rheumatology and infusion services.

This is a full-time role, Monday - Friday, 8am-5pm out of our Woodbury clinic.

Twin Cities Orthopedics is an operating division of Infinite Health Collaborative (i-Health), a group of local medical practices, owned and led by its physicians, on a mission to give patients more control over their healthcare.

Essential Functions:

• Lead and support a team responsible for managing prior authorizations and scheduling for rheumatology and infusion patients.
• Serve as a point of contact for complex cases and escalation support.
• Collaborate with providers, clinical staff, and insurance companies to ensure efficient workflow and patient care.
• Monitor performance metrics and assist in process improvement initiatives.
• Any and all other duties as assigned

Education and Experience Requirements:

• High school diploma/GED or equivalent
• 2 years prior authorization experience
• Medical terminology knowledge strongly preferred
• Minimum of 1 year of leadership experience in a healthcare or administrative setting.
• Strong understanding of prior authorization processes and infusion scheduling.
• Excellent communication, organizational, and problem-solving skills.
• Ability to work independently and as part of a collaborative team.
• Customer service experience

Benefits & Compensation:  

• Actual starting pay will vary based on education, skills, and experience.
• We offer a comprehensive Medical, Dental & Vision Plan, Maternity Bundle, 401K with Profit Sharing, Tuition Reimbursement, Gym & Car Rental Discounts - to learn more click here.

Essential Requirements:

Ability to:

• Comply with company policies, procedures, practices, and business ethics guidelines.
• Complete job-required training.
• Comply with all applicable laws and regulations, (e.g. HIPAA, Stark, OSHA, employment laws, etc.)
• Demonstrate prompt and reliable attendance.
• Work in the clinic or office during business hours 
• Travel independently throughout the clinic, office, or surgery center (which may include movement from floor to floor); frequent bending, lifting, standing, stooping, or sitting for long periods may be required.
• Work at an efficient and productive pace, handle interruptions appropriately, and meet deadlines.
• Communicate and interact respectfully and professionally.
• Prioritize workload while being flexible to meet the expectations of the daily operations.
• Apply principles of logical thinking to define problems, establish facts, and draw valid conclusions.
• Understand and execute a variety of instructions.
• Effectively operate equipment and communicate on and operate the phone system.
• Work independently with minimal supervision
• Travel to other work locations, if required

Performance Expectations – i-Health’s Core Values:

• Integrity - Do the right thing and take responsibility for what you do and say.
• Service - Consistently contribute to deliver an exceptional experience.
• Quality - Act with high purpose, committed effort, and skillful execution to exceed expectations.
• Innovation - Identify progressive solutions that improve service, teamwork, efficiency, and/or effectiveness.
• Teamwork - Be a part of the whole; support each other positively.

Notes:

• Infinite Health Collaborative (i-Health) is an Equal Opportunity/Affirmative Action Employer and will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990 and the ADA Amendments Act of 2008. 
• We participate in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here:  http://www.uscis.gov/e-verify/employees
• This position description will be reviewed periodically as duties and responsibilities change with business necessity. Essential and Additional Job Functions are subject to modification.