Top 233 Prior authorization lead Jobs in Columbus, Oh

Lead Reimbursement Analyst
Gifthealth Inc —Columbus, OH
- $31.47 - $39.34 an hour
- Weekends as needed
- Remote
- Research
- Analysis skills
- Supervising experience
Quick Apply
2d
Correction Records Sentence Computation/Release Officer (BOSC)- 20017709
State of Ohio - Rehabilitation & Correction - Operation Support Center —Columbus, OH
- $24.88 an hour
- Online Application
- Basic math
- English
- Research
8d
Correction Records Sentence Computation/Release Officer (BOSC)-20082857
State of Ohio - Rehabilitation & Correction - Operation Support Center —Columbus, OH
- $24.88 an hour
- Online Application
- Basic math
- English
- Research
8d
Medical Administrative Assistant
Pain Zero LLC —Westerville, OH
- $20 - $23 an hour
- Full-time
- Background check
- Medical office experience
- Administrative experience
- Paid time off
Quick Apply
8d
Sr. Manager, Account Operations - Prior Authorization Network
McKesson —Columbus, OH
- $97,900 - $163,100 a year
- Mentoring
- Contracts
- Experience equivalent to degree accepted
6d
Lead Medical Receptionist
Center for Vein Restoration —Grove City, OH
- $19.00 - $19.25 an hour
- Full-time
- HIPAA
- Mid-level
- Administrative experience
- Paid holidays
- Health insurance
Quick Apply
Associate Director Shared Services
Equitas Health, Inc. —Columbus, OH
- $98,500 - $118,200 a year
- Weekends as needed
- Microsoft Excel
- Microsoft Access
- Microsoft Outlook
- Dental insurance
- Paid time off
Quick Apply
6d
Patient Access Lead- Ambulatory Clinics
Nationwide Children's Hospital —Columbus, OH
- Full-time
- Management
- Mid-level
- Ability to climb stairs
Manager SOX Compliance (hybrid)
NiSource —Columbus, OH
- $133,400 - $200,100 a year
- Full-time
- Hybrid work
- Office
- Master's degree
- Bachelor's degree
7d
Billing Specialist I
Ohio Gastro —Columbus, OH
- Microsoft Excel
- HIPAA
- English
Quick Apply
Financial Manager
State of Ohio - Budget and Management —Columbus, OH
- $92,310 - $131,893 a year
- Full-time
- Management
- Office
- Finance
- Paid holidays
- Health insurance
3d
Assoc Field Access Dir, Derm, Columbus, OH
Incyte Corporation —Columbus, OH
- $196,000 - $218,000 a year
- Bachelor's degree
- Continuous improvement
- Experience equivalent to degree accepted
Sr. Account Operations Manager - Prior Authorization Network
McKesson —Columbus, OH
- $75,800 - $126,300 a year
- Bachelor's degree
- Organizational skills
- Senior level
6d
Service and Support Administrator
Delaware County, OH —Delaware, OH
- $54,121.60 - $69,825.60 a year
- Weekends as needed
- Clean driving record
- Mid-level
- Office
- Health insurance
- Dental insurance
Physical Fitness Coordinator (PRN)
Concentric Methods —Columbus, OH
- $37.87 an hour
- PRN
- CPR Certification
- Mid-level
- US work authorization
- 401(k) matching
Oracle Utilities Integration Lead
Accenture —Columbus, OH
- $87,400 - $266,300 a year
- Full-time
- Management
- 5 years
- System design
- Paid holidays
- Disability insurance
Project Manager (HE LLC)
HANLEY ENERGY GROUP —Dublin, OH
- $80 - $120 an hour
- Full-time
- Mid-level
- Microsoft Office
- Analysis skills
- Paid time off
Clinical Management Manager
Accenture —Columbus, OH
- $87,400 - $293,800 a year
- Full-time
- Bachelor's degree
- Travel
- US work authorization
- Paid holidays
- Disability insurance
Assistant Director, Accounting Invest Operations
State Teachers Retirement System of Ohio —Columbus, OH
- $162,830 - $207,609 a year
- Full-time
- CPA
- Pass drug screening
- Office
- Free parking
- Health insurance
Oracle Utilities Meter Data Management (MDM) Functional Lead
Accenture —Columbus, OH
- $59,100 - $196,000 a year
- Full-time
- Oracle
- Team management
- Mentoring
- Paid holidays
- Disability insurance

I want to receive the latest job alert for prior authorization lead in columbus, oh

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

prior authorization lead jobs near columbus, oh

Lead Reimbursement Analyst

Gifthealth Inc -
Columbus, OH

Quick Apply

Job Details

Full-time
$31.47 - $39.34 an hour
2 days ago

Qualifications

Team supervision
Medical coding
Research
Incident Escalation
Documentation tools
Productivity software
Escalation handling
Medical terminology
General management
Cross-functional communication
Quality data entry
Analytics

Full Job Description

About Us

At Gifthealth, we’re revolutionizing the way people experience healthcare by simplifying the process of managing prescriptions and health services. Our mission is to provide a seamless, personalized, and efficient healthcare experience for all our customers. We’re a dynamic, innovative, and customer-centric company dedicated to making a positive impact on people’s lives.

Position Summary

The Lead Reimbursement Analyst serves as a working team lead within the reimbursement organization, combining advanced reimbursement expertise with direct people leadership responsibilities. This role manages a team of Reimbursement Analysts while maintaining ownership of complex reimbursement cases, escalations, quality initiatives, and operational performance. The Lead Reimbursement Analyst is responsible for coaching, developing, and supporting team members, ensuring adherence to client requirements, quality standards, and service level expectations. This role partners closely with leadership to drive operational excellence, employee engagement, and continuous process improvement. This is a fully remote, desk-based role with frequent phone and computer use.

Requirements

Key Responsibilities

Advanced Reimbursement & Case Management Serve as the primary point of contact for moderate to complex reimbursement cases including insurance benefit investigations, prior authorizations, appeals, and patient assistance programs; manage and resolve escalated cases requiring advanced research, payer interaction, or clinical coordination; review and resolve denied or underpaid claims; research and apply payer medical policies, prior authorization requirements, and coverage guidelines; identify patient-specific insurance coverage options; reverify patient benefits at predetermined timeframes and document all activities within required timelines
Leadership, Mentorship & Quality Support Provide direct supervision, coaching, and performance management for a team of Reimbursement Analysts, including goal setting, performance feedback, and employee development; conduct regular one-on-one meetings, performance discussions, and career development planning; support recruiting, interviewing, onboarding, and training of new team members; monitor team productivity, quality, and service level metrics and implement corrective actions as needed; serve as the primary escalation point for complex reimbursement cases and operational issues; act as a subject matter expert and resource for reimbursement workflows, payer policies, and client requirements; identify trends in errors, denials, or workflow inefficiencies and implement solutions to improve team performance; assist with drafting, maintaining, and communicating SOPs, work instructions, and quality standards; foster a positive, collaborative, and accountable team environment.
Client & Cross-Functional Support Serve as a point of contact for internal teams and external stakeholders including payers, healthcare providers, patients, and client representatives; may act as a regional or program-specific contact for senior-level client contacts; assist with coordination of tasks and communication between Gifthealth, clients, and internal partners; prepare or assist with preparation of internal and client-facing reports including adverse event and product complaint documentation as required
Operational Support Monitor and communicate updates related to payer policies, coverage changes, and prior authorization requirements; assist in testing and feedback for CRM, telephony, and system tools related to reimbursement workflows; participate in client calls, meetings, off-site trainings, and conferences as needed; travel estimated at up to 5%

Qualifications

Education

Bachelor’s degree or equivalent relevant experience (Required)

Experience

Minimum 4 years of recent healthcare/medical & billing experience with at least 1-2 years of leadership, supervisory, team lead, or people management experience preferred (Required)
2 years of direct reimbursement, specialty pharmacy, hub services, or patient support program experience preferred (Required)
Call center experience, client interaction experience, and experience leading or mentoring team members (Preferred)
Active Pharmacy Technician Trainee license or ability to obtain one within 90 days of hire (Required)

Knowledge, Skills & Abilities

Advanced knowledge of medical insurance (public and commercial), billing and coding, and associated terminology (Required)
Advanced written and verbal communication skills; strong customer service skills; demonstrated ability to collaborate cross-functionally and escalate issues appropriately (Required)
High attention to detail with strong data entry accuracy; advanced problem-solving, research, and analytical skills (Required)
Ability to manage time independently, prioritize workload, and multitask in a fast-paced environment; proficiency in Microsoft Office Suite (Required)

Work Environment

Location: Remote; desk-based role with frequent phone and computer use and minimal physical requirements
Schedule: Monday through Friday, 8:00 AM to 8:00 PM EST (40 hours/week); shift start times may range from 8:00 AM to 11:00 AM EST; occasional weekend hours may be required to support client needs
Works closely with Reimbursement Analysts, Supervisors, and Program Managers; maintains direct contact with healthcare providers, patients, payers, and client representatives

Employment Classification

Status: Full-time

FLSA: Non-Exempt

Equal Employment Opportunity (EEO) Statement

Gifthealth is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. All employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, transgender status, national origin, age, disability, veteran status, or any other legally protected status.

Disclaimer

This job description is intended to describe the general nature and level of work being performed. It is not intended to be an exhaustive list of all responsibilities, duties, or skills required of personnel. Gifthealth reserves the right to modify job duties or descriptions at any time.

Quick Apply

Refine Your Search

prior authorization lead jobs in columbus, oh

Lead Reimbursement Analyst

Correction Records Sentence Computation/Release Officer (BOSC)- 20017709

Correction Records Sentence Computation/Release Officer (BOSC)-20082857

Medical Administrative Assistant

Sr. Manager, Account Operations - Prior Authorization Network

Lead Medical Receptionist

Associate Director Shared Services

Patient Access Lead- Ambulatory Clinics

Manager SOX Compliance (hybrid)

Billing Specialist I

Financial Manager

Assoc Field Access Dir, Derm, Columbus, OH

Sr. Account Operations Manager - Prior Authorization Network

Service and Support Administrator

Physical Fitness Coordinator (PRN)

Oracle Utilities Integration Lead

Project Manager (HE LLC)

Clinical Management Manager

Assistant Director, Accounting Invest Operations

Oracle Utilities Meter Data Management (MDM) Functional Lead

I want to receive the latest job alert for prior authorization lead in columbus, oh

Related Searches

Explore jobs in more locations

Requirements

Job Seeker Tools

Employer Tools

Browse

Stay Connected