Days & Authorizations Manager

Description

Job Summary: 

The Days & Authorizations Manager is responsible for overseeing the daily operations of the authorizations team to ensure timely and accurate processing of insurance prior authorizations for all medical services. This role provides strategic oversight, performance management, and process improvement for the authorizations department. In addition, the Days & Authorizations Manager will be responsible for overseeing the Days team, which handles chart preparation prior to patient appointments to ensure a smooth clinical workflow.

This role also serves as a key resource for clinic operations, providing problem-solving support for staff, doctors, and patients, and functions as a Clinic Manager.

Job Duties and Responsibilities: 

Team Leadership & Oversight

• Supervise and manage the Authorizations team, including supervisors, leads, and coordinators.
• Provide direct oversight and support to the Days team responsible for patient chart preparation, ensuring timely and complete chart prep in advance of all scheduled appointments.
• Set clear performance expectations, monitor productivity metrics, and provide coaching and performance evaluations.
• Lead team meetings, trainings, and cross-functional huddles to ensure alignment with departmental and clinic-wide goals.

Authorization Operations

• Oversee the full cycle of prior authorizations for services including diagnostics, surgeries, procedures, ancillary products and referrals.
• Ensure timely submission and follow-up on all authorization requests according to payer timelines.
• Monitor team workloads and reassign tasks as necessary to maintain efficiency and turnaround times.

Days Team Oversight

• Ensure patient charts are reviewed, prepared, and completed in accordance with clinic protocols and provider preferences.
• Work with clinical staff to identify missing documentation, eligibility issues, or other barriers to smooth check-in and service delivery.
• Monitor quality and accuracy of chart prep and address any recurring issues or training needs.

Compliance & Quality Assurance

• Maintain knowledge of payer policy changes and ensure compliance with all authorization and chart documentation requirements.
• Audit processes for accuracy and completeness, addressing any delays or gaps proactively.
• Uphold high standards of documentation across both the authorizations and chart prep teams.

Clinic Management & Problem Solving

• Support clinic operations by resolving issues involving authorizations, patient readiness, staff concerns, or provider needs.
• Act as a liaison between back-office support teams and clinical teams to promote collaboration and workflow efficiency.
• Address urgent issues in real-time to minimize disruption to patient care or clinic flow.
• Support leadership in improving patient access, communication, and satisfaction.
• Function as Clinic Manager and manage workflow during a clinic day, including but not limited to involvement with managing reception, medical assistant department personnel in conjunction with their department managers

Process Improvement & Reporting

• Identify opportunities to streamline both authorizations and chart prep workflows.
• Develop SOPs, training materials, and tools to support consistency and efficiency.
• Generate and analyze reports on team performance, turnaround times, and process bottlenecks.
• Other duties as assigned

Requirements

Qualifications and Experience:

• High school diploma or equivalent required; Bachelor's degree in Healthcare Administration, Business, or related field preferred.
• Minimum 3–5 years of experience in prior authorizations or chart prep within a medical practice.
• Minimum 2 years in a supervisory or leadership role within a healthcare setting.
• Strong knowledge of insurance plans, pre-certification processes, medical chart workflows, and medical terminology.
• Experience with EHR systems and practice management software.
• Excellent communication, problem-solving, and organizational skills.
• Ability to multitask and lead calmly in a fast-paced clinical environment.
• Bonus if candidate has experience working in or supporting an ENT (Ear, Nose & Throat) specialty practice, including familiarity with ENT-specific procedures, diagnostics, and payer requirements.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The individual will be required to:

• Sit for long periods at a time.
• Use hands and fingers in repetitive motions, daily.
• Ability to lift, push and pull up to 20 lbs. periodically.
• Travel to clinic locations or sites as needed.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.