Forta is hiring a
Medical Authorization Team Lead

Summary

The Medical Authorization Team Lead at Forta will streamline prior authorization and single case agreement processes with insurance companies, manage a team, and ensure efficient operations. This role requires a bachelor's degree, knowledge of medical billing procedures, strong attention to detail, excellent organizational skills, proficiency in using Google Workspace, ability to work independently, and maintain confidentiality.

Requirements

• Bachelor's degree is required, specialization in healthcare administration, business administration, or a related field is preferred but not required
• Knowledge of medical billing procedures, including insurance billing, coding, and claim submission processes, and experience in medical billing, specifically in prior authorization management and single case agreements are a plus
• As this is a fully remote position, you must have a reliable internet connection and be able to provide your own computer and equipment
• Strong attention to detail and ability to manage multiple tasks simultaneously
• Excellent organizational, communication, and interpersonal skills
• Proficiency in using Google Workspace
• Ability to navigate complex systems and processes
• Ability to work independently and prioritize tasks to meet deadlines
• Maintaining confidentiality and adhering to ethical standards in handling sensitive patient information

Responsibilities

• Lead and manage a team of 5-10 associates responsible for prior authorization tasks
• Provide training and coaching to associates on their responsibilities and tasks
• Monitor, assess, and improve team performance to ensure they meet or exceed metrics and stay on track daily
• Initiate and manage the prior authorization process with various insurance companies
• Review patient medical records, treatment plans, and other relevant documentation to gather necessary information for authorization requests
• Collaborate with healthcare providers and other stakeholders to obtain additional documentation or clarifications as needed
• Ensure that all prior authorization forms and supporting documents are accurately completed and submitted within established timelines
• Research and identify insurance companies that require single case agreements for specific treatments or services
• Liaise with insurance companies to negotiate and establish single case agreements
• Coordinate with the internal team to ensure that all necessary information is included in the billing documentation to comply with single case agreement requirements

Benefits

The position offers a salary range of ₱375 - ₱469 an hour