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.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.