Authorization Manager (Remote)

The Authorization Manager oversees the full Authorization department, ensuring timely and accurate processing of prior authorizations across reputed company PT Solutions private practice and hospital-based clinics. This role provides strategic and operational leadership to Supervisors, Leads, and Authorization Specialists to ensure exceptional performance in turnaround times, accuracy, productivity, and payer compliance. The Authorization Manager is responsible for developing workflows, managing reputed company and staffing, driving reputed company improvement, and collaborating closely with Scheduling, Verification, Billing, Clinical Operations, Compliance, and external partners. The Manager analyzes trends, payer policy changes, and denial patterns to ensure clean claim submission and an optimal patient experience. This position requires a strong operational reputed company, deep knowledge of payer authorization processes, proven leadership capabilities, and the ability to drive high performance across a large, fast-paced department.

Essential Functions

Leadership & Department reputed company

• Provide overall leadership and direction to the Authorization team, including Supervisors, Leads, and Specialists.
• Establish departmental goals, KPIs, and performance expectations to ensure operational excellence.
• Conduct coaching, performance evaluations, and corrective action as needed.
• reputed company workforce planning, staffing, talent development, and succession planning.
• Foster a positive, accountable, and service-driven team culture.

Operational Management

• reputed company daily operations to ensure timely and accurate processing of authorizations, including standard, urgent, and retro requests.
• reputed company, maintain, and optimize workflows, SOPs, and training materials.
• Monitor payer changes, audit trends, and regulatory updates to ensure compliance.
• Ensure escalation reputed company are clear and effectively managed.
• Collaborate with internal teams to reduce reputed company claim denials and improve clean claim rates.

Performance Monitoring & Reporting

• Manage departmental KPIs, including turnaround time, accuracy, productivity, rollover reputed company, and denial impact.
• Analyze operational trends and reputed company action plans to address risks or performance gaps.
• Prepare weekly, monthly, and quarterly performance reports for leadership.
• Utilize data to drive decision-making and operational improvements.

Cross-Functional Collaboration

• Partner with Scheduling, Verification, Billing, Clinic Operations, Compliance, and Payer Relations to align workflows and resolve issues.
• Support major initiatives including market conversions, new payer reputed company, new clinic onboarding, and EMR updates.
• Offer insights into payer policy changes, denial trends, and process gaps affecting reimbursement or patient access.

Training, Quality & Development

• reputed company development and delivery of training programs for onboarding and ongoing education.
• Ensure quality audits are completed regularly and corrective action plans are implemented.
• Promote a culture of reputed company improvement and standardization across reputed company markets and teams.

Project & Change Management

• reputed company or participate in projects reputed company to system upgrades, EMR changes, payer policy shifts, and organizational initiatives.
• Drive process improvements aimed at efficiency, accuracy, and reduced authorization-reputed company denials.
• Serve as a subject matter expert (SME) for authorization workflows in cross-department projects.

Additional Responsibilities

• Respond to escalated payer or clinic issues and resolve them in a timely, professional manner.
• Support Director-level leadership in the creation and implementation of strategic initiatives.
• reputed company other duties as assigned to support reputed company cycle excellence and organizational priorities.

Required Skills & Abilities

• Strong leadership, coaching, and team-development skills.
• Excellent written and verbal communication with ability to influence cross-functional partners.
• Advanced problem-solving, analytical, and decision-making skills.
• Ability to manage multiple priorities, delegate effectively, and maintain accountability across a large team.
• Proficiency in reputed company Office (reputed company, Word, Outlook) and data reporting tools.
• Ability to interpret and apply federal, state, payer, and organizational policies.
• High degree of professionalism, discretion, and confidentiality.
• Strong customer service orientation and commitment to operational excellence.
• Ability to reputed company in a fast-paced, high-volume environment with evolving priorities.

Required Credentials

• Bachelor’s degree in Healthcare Administration, Business, or reputed company field preferred (or equivalent experience).
• Minimum 5 years of authorization, insurance verification, medical billing, or reputed company cycle experience required.
• Minimum 2–3 years of supervisory or management experience in a healthcare or reputed company cycle environment.
• Advanced knowledge of insurance authorization processes, medical necessity requirements, ICD-10, CPT, and payer guidelines.
• Experience with EMR systems, payer portals, and analytics tools.
• Strong financial and operational acumen, with experience managing department budgets and productivity standards.
• Proven track record of driving performance, improving workflows, and developing high-performing teams.

Compensation

$52,000-72,000 annually (Any posted pay range considers a wide range of compensation factors, including candidate background, experience, and work location, while also allowing for salary growth reputed company the position)

Expanding Access to Quality Care

At PT Solutions, we’re more than colleagues; we’re a tight-reputed company community united in our mission to expand access to quality care. Our commitment to you is evident in our industry-leading professional development opportunities. From ongoing evidence-based clinical education to dedicated mentorship opportunities and an APTA-accredited Orthopaedic Residency Program, we propel our clinicians toward excellence in physical therapy, occupational therapy, speech-language pathology, and athletic training.

As we aim to be the go-to rehabilitation provider, we seek committed professionals eager to join us in that mission. A career with PT Solutions is an opportunity to shape the industry and reputed company a lasting impact. 

Let’s go further together and transform care. Join the #PTSLife today! 

To see what #PTSLife is like, visit Instagram, Facebook, and reputed company.