Pre-Certification Supervisor

Description

Pre-Certification Supervisor – Georgia Urology

About the Role
Georgia Urology is seeking a Pre-Certification Supervisor to lead and support the daily operations of the pre-certification and prior authorization team. This role is responsible for overseeing the authorization process for procedures and services to ensure accurate and timely approvals for our physicians and patients.

The ideal candidate is a strong operational leader who thrives in a fast-paced healthcare environment and can effectively manage high-volume workflows while maintaining accuracy and compliance with payer requirements. This position will focus on optimizing processes, supporting team development, and ensuring efficient coordination between scheduling, clinical teams, anesthesia partners, and revenue cycle departments.

Responsibilities

• Supervise and support the end-to-end pre-certification and prior authorization process, including insurance verification, documentation review, submission, and payer follow-up.
• Ensure timely and accurate authorizations for procedures and anesthesia services across multiple Georgia Urology locations.
• Monitor daily work queues to ensure authorizations are completed prior to scheduled procedures and reduce delays or rescheduling of patient care.
• Develop and maintain efficient workflows to improve turnaround times and authorization approval rates.
• Collaborate with scheduling teams, clinical staff, anesthesia partners, and revenue cycle departments to ensure accurate information flow and documentation for authorizations and billing.
• Track and analyze key performance indicators (KPIs) such as authorization turnaround time, approval rates, and denial trends to identify opportunities for process improvement.
• Train, mentor, and support pre-certification team members to ensure consistent adherence to payer guidelines, internal policies, and best practices.
• Maintain current knowledge of insurance payer policies, medical necessity requirements, and authorization guidelines, including Medicare, commercial, and managed care plans.
• Develop and maintain standard operating procedures (SOPs), reference guides, and documentation to support consistent team performance and onboarding of new staff.
• Serve as a resource for escalated authorization issues, payer denials, or complex cases requiring additional follow-up or documentation.

Qualifications

• 5–8 years of experience in healthcare operations, prior authorizations, pre-certification, or revenue cycle management, preferably in a specialty practice.
• Previous supervisory or team lead experience strongly preferred.
• Strong knowledge of insurance verification, payer authorization requirements, and medical necessity documentation.
• Experience working with EHR/EMR systems and scheduling platforms in a multi-provider practice.
• Excellent organizational and problem-solving skills with the ability to manage high-volume workflows and competing priorities.
• Strong communication skills with the ability to collaborate across clinical, scheduling, billing, and external partners such as anesthesia groups.
• Detail-oriented with a focus on accuracy, compliance, and patient experience.

Requirements

Qualifications

• 5–8 years of experience in healthcare operations, prior authorizations, pre-certification, or revenue cycle management, preferably in a specialty practice.
• Previous supervisory or team lead experience strongly preferred.
• Strong knowledge of insurance verification, payer authorization requirements, and medical necessity documentation.
• Experience working with EHR/EMR systems and scheduling platforms in a multi-provider practice.
• Excellent organizational and problem-solving skills with the ability to manage high-volume workflows and competing priorities.
• Strong communication skills with the ability to collaborate across clinical, scheduling, billing, and external partners such as anesthesia groups.
• Detail-oriented with a focus on accuracy, compliance, and patient experience.