What are the responsibilities and job description for the Pre-Certification Specialist Lead position at Resurgens Orthopaedics?
Job Type
Full-time
Description
SUMMARY
The Pre-Certification Specialist Lead oversees the daily operations of the Patient Access team, ensuring efficient and accurate patient registration, scheduling, insurance verification, and authorization processes. This role is responsible for supervising Pre-Certification Specialist team, providing training, monitoring performance, and maintaining compliance with organizational policies and regulatory requirements. The supervisor ensures exceptional customer service and fosters a positive work environment.
ESSENTIAL DUTIES AND RESPONSIBILITIES (Other Duties May Be Assigned)
Leadership & Supervision
Directly supervises Pre-Certification Specialists, including hiring, onboarding, scheduling, and
performance evaluations.
Monitors daily workflows to ensure timely and accurate completion of patient access functions.
Provides coaching and feedback to staff to maintain high standards of service and productivity.
Training & Development
Implements training programs for staff in all areas: Check-in/out, Chart Auditing, Call Center, Scheduling,
Insurance Verification, and Authorization submission.
Ensures staff competency and compliance with organizational policies and procedures.
Operational Oversight
Maintains Adherence To HIPAA And Other Regulatory Requirements.
Reviews and audits patient access processes for accuracy and efficiency.
Collaborates with other departments to resolve issues and improve workflows.
Customer Service
Promotes a culture of excellent patient service by modeling and reinforcing positive behaviors.
Handles escalated patient concerns and resolves issues promptly and professionally.
Reporting & Compliance
Prepares and analyzes reports related to patient access performance metrics.
Ensures compliance with organizational standards and payer requirements.
Other Duties
Participates in departmental meetings and organizational initiatives.
Performs other related duties as assigned.
Requirements
QUALIFICATIONS
Education
High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
Experience
Minimum 2–3 years of experience in patient access or healthcare registration.
Skills
Prior supervisory or leadership experience preferred.
Strong leadership and team-building skills.
Excellent communication and interpersonal abilities.
Proficiency in scheduling systems, insurance verification, and authorization processes.
Proficient in leveraging technology to optimize workflows, ensure data accuracy, and support
efficient patient access operations
Ability to manage multiple priorities in a fast-paced environment.
Core Competencies
Customer Service Excellence
Attention to Detail
Problem-Solving
Compliance and Confidentiality
Team Leadership
Use of Technology
PHYSICAL DEMANDS
Hearing: Adequate to perform job duties in person and over the telephone.
Speaking: Must be able to clearly communicate in person and over the telephone.
Vision: Visual acuity adequate to perform job duties, including visual examination of patient (if applicable) and reading information from printed sources and computer screens.
Other: Adequate physical ability includes sufficient manual dexterity to perform the requisite job duties. Job duties may require bending, reaching, repetitive hand movements, standing, walking, squatting, sitting and occasional heavy lifting, pushing and pulling.
WORK ENVIORNMENT
Work environment is typical of an office setting. Work may be fast-paced and intense at times. Interaction with others is constant and interruptions may occur. Schedule requires flexibility to occasionally include evenings, early mornings, and weekends.
The above describes the general content of and requirements for the performance of this position. It is not intended to be an all-inclusive statement of the duties, responsibilities, and requirements of the position.
Full-time
Description
SUMMARY
The Pre-Certification Specialist Lead oversees the daily operations of the Patient Access team, ensuring efficient and accurate patient registration, scheduling, insurance verification, and authorization processes. This role is responsible for supervising Pre-Certification Specialist team, providing training, monitoring performance, and maintaining compliance with organizational policies and regulatory requirements. The supervisor ensures exceptional customer service and fosters a positive work environment.
ESSENTIAL DUTIES AND RESPONSIBILITIES (Other Duties May Be Assigned)
Leadership & Supervision
Directly supervises Pre-Certification Specialists, including hiring, onboarding, scheduling, and
performance evaluations.
Monitors daily workflows to ensure timely and accurate completion of patient access functions.
Provides coaching and feedback to staff to maintain high standards of service and productivity.
Training & Development
Implements training programs for staff in all areas: Check-in/out, Chart Auditing, Call Center, Scheduling,
Insurance Verification, and Authorization submission.
Ensures staff competency and compliance with organizational policies and procedures.
Operational Oversight
Maintains Adherence To HIPAA And Other Regulatory Requirements.
Reviews and audits patient access processes for accuracy and efficiency.
Collaborates with other departments to resolve issues and improve workflows.
Customer Service
Promotes a culture of excellent patient service by modeling and reinforcing positive behaviors.
Handles escalated patient concerns and resolves issues promptly and professionally.
Reporting & Compliance
Prepares and analyzes reports related to patient access performance metrics.
Ensures compliance with organizational standards and payer requirements.
Other Duties
Participates in departmental meetings and organizational initiatives.
Performs other related duties as assigned.
Requirements
QUALIFICATIONS
Education
High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
Experience
Minimum 2–3 years of experience in patient access or healthcare registration.
Skills
Prior supervisory or leadership experience preferred.
Strong leadership and team-building skills.
Excellent communication and interpersonal abilities.
Proficiency in scheduling systems, insurance verification, and authorization processes.
Proficient in leveraging technology to optimize workflows, ensure data accuracy, and support
efficient patient access operations
Ability to manage multiple priorities in a fast-paced environment.
Core Competencies
Customer Service Excellence
Attention to Detail
Problem-Solving
Compliance and Confidentiality
Team Leadership
Use of Technology
PHYSICAL DEMANDS
Hearing: Adequate to perform job duties in person and over the telephone.
Speaking: Must be able to clearly communicate in person and over the telephone.
Vision: Visual acuity adequate to perform job duties, including visual examination of patient (if applicable) and reading information from printed sources and computer screens.
Other: Adequate physical ability includes sufficient manual dexterity to perform the requisite job duties. Job duties may require bending, reaching, repetitive hand movements, standing, walking, squatting, sitting and occasional heavy lifting, pushing and pulling.
WORK ENVIORNMENT
Work environment is typical of an office setting. Work may be fast-paced and intense at times. Interaction with others is constant and interruptions may occur. Schedule requires flexibility to occasionally include evenings, early mornings, and weekends.
The above describes the general content of and requirements for the performance of this position. It is not intended to be an all-inclusive statement of the duties, responsibilities, and requirements of the position.