Pre-Certification Specialist Lead

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.

Prior supervisory or leadership experience preferred.

Skills:

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.