Position Summary

The Team Lead manages a team of 3-5 associates handling out-of-network authorization requests from intake through final determination. They are responsible for their team’s performance and maintaining high-quality work standards. They monitor day-to-day tasks, provide support, and address any issues that may impact productivity or accuracy.

Additionally, they serve as a communication bridge between the team and leadership, ensuring goals and expectations are clearly understood and achieved.

Key Responsibilities

• Responsible for overall performance of their entire They are expected to answer for the behaviors and performance of their entire team, and, where needed, escalate concerning or improper behaviors.
• Role model positive behavior, work ethic, and adherence to company
• Use Salesforce reporting to oversee daily team operations to ensure tasks are completed accurately and on
• Help identify and inform solutions to workflow issues or obstacles preventing efficiency and optimal
• Own training process for new employees from inception to independent Advocate.
• Provide coaching, feedback and support to help team members manage cases and escalate where Be an expert in insurance policy, case strategy and driving approvals.
• Collaborate with other peers to strategize on best practice to navigate individual insurance policies and complex
• Act as a liaison between specialty teams (coders, IT, execs), operations and leadership.
• Maintain efficient workflows while coordinating and delegating tasks as
• Effectively identify strengths and weaknesses of all team members and create improvement plans to help support Proactively inform management when needed.
• Deliver timely updates, reporting, and weekly status reports to
• Ownership of individual team meetings, weekly 1:1 with all members of team, and twice weekly office

Key Performance Indicators (KPIs):

• Team approval rate
• Total team case volume
• Average case duration (intake to determination)
• Case accuracy (documentation, coding alignment, policy interpretation)
• Timely submission rate (authorizations and appeals within payer deadlines)
• Salesforce hygiene (proper staging, documentation, and task management)
• Advocate productivity and new hire ramp time
• Team engagement and retention

Required Skills & Competencies

• Problem Solving: Resourceful, persistent, and comfortable navigating complex insurance
• Organized & Detail-Driven: Strong time management skills with the ability to manage team of
• Strategic Thinking: Able to analyze policy language and develop creative, compliant approaches to achieve favorable
• Professional Communication: Clear, respectful, and confident when interacting with insurers, providers, patients, and internal
• Self-Motivated: Works independently, takes ownership of outcomes, and consistently seeks to learn and
• Cross-Functional Collaboration: With remote team members, Upper Management, Coders, IT, Clients, Insurance Carriers, In-Network & Out-of- Network Providers, and Patients

Tools & Systems

Case & Reporting Platforms: Salesforce, QuickBase, Power BI Communication: Microsoft Teams, Email, Phone