Prior Authorization Specialist - Team Lead
Each day you are in the office the lives of patients will be improved.
This is not your typical prior authorization job. As the Leader of our Prior Authorization Team, you will leverage your verification and authorization expertise to research payers/ insurance information to update and maintain our business rules library, (a critical part of our software), with the most up to date coverage information. As this is a brand new team and role for Myndshft, you will have the opportunity to grow your career by leading a team at the ground level, shaping our approach to obtaining prior authorization requirements from insurance companies.This is a mission critical role, as we require your knowledge and expertise to ensure our products work as intended. As a "working manager" you will work alongside the people you lead, while also providing the team guidance and direction. In this role you will:
- Find, read, understand, and parse prior authorization and medical necessity rules and regulations set by insurance companies.
- Use an internal tool to populate unformatted insurance and authorization requirements into a common format.
- Keep documentation updated when changes are made to prior auth requirements by insurance companies.
- Interface with software development teams to suggest and QA functionality added to rules engine products and UI for data population.
- Interface with customers to parse contractual rules and update them into a standard format in the Myndshft rules engine.
- Lead, inspire, and motivate a small Team of Prior Authorization Specialists & Business Analysts.
- Meet 1:1 with other Prior Auth Specialists to drive their performance.
- Establish and train team members on best practices related to this role.
- Establish and document standard operating procedures for how work on this team is performed. Leverage the insight and contributions of the team to accomplish this.
- Collaborate cross functionally with Product Owners, Software Engineering Leads, and Sales Leadership to manage the workflow and load of other Prior Authorization Specialists.
- Communicate and collaborate with business leadership to determine appropriate staffing and resources for the team to successfully accomplish the work to be performed.
- Experience researching and obtaining prior authorization, and navigating insurance verification. You know exactly where to find this information, and how to interpret the requirements. You've likely been doing this for at least 4 years.
- Proven leadership skills. You have led, motivated, trained, and inspired high performing teams focused on prior authorization.
- Excellent research and comprehension skills when navigating insurance jargon related to prior authorization and medical necessity.
- High level of comfort navigating new, unfamiliar technologies without training or guidance.
- Ability to work collaboratively, independently, and reliably.
- A self-starting mindset. You aren't waiting to be told what to do. You ask questions, determine what needs to be done, and do it until it's complete and correct.
- Proficiency in spreadsheets (Excel, Google Sheets, Smartsheets, or other spreadsheet software).
Desired (bus not required) skills
- Higher Education in Health Information Technology, Health Information Management, RHIT certification, or related education
- Experience obtaining authorizations for diagnostic labs, genomics, or speciality pharmacy
- Competitive salary that correlates with your ability to contribute
- Generous vacation + sick time allotment
- 4 hours/ month paid community service time
- Equity incentive plan
- Medical, Dental, & Vision, GTL, STD, LTD Insurance with employer contribution
- 401k + Employer Match
- Fun office perks including snack bar, dog-friendly environment, recreation room, modern layout, and indoor/ outdoor transitional space
- Continued learning in form of brown bag lunches, training sessions and intra-company events.
Myndshft’s software-as-a-service automates and simplifies time-consuming healthcare administrative tasks associated with prior authorization, eligibility and benefits verification, and patient financial responsibility, freeing providers and payers to concentrate more fully on patient care again. Myndshft was founded in 2015, and works with leading providers, payers, and health information exchanges.
COMMITMENT TO DIVERSITY & INCLUSION
We value diversity and inclusion, and strive to build teams which include people from a variety of backgrounds, perspectives, and skills. Diversity makes us tick, and we are better together. That said, we are an equal opportunity employer. You will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
This job description is subject to change at any time. We are a startup, and we all wear many hats. As part of your employment, you may be asked to perform duties outside of this job description. Please see your immediate supervisor with any questions you may have.