Team Lead
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Team LeadOmega Healthcare Management Services • Pasig, National Capital Region, Philippines
Team Lead
Omega Healthcare Management Services • Pasig, National Capital Region, Philippines
10 days ago
Job description
Job Duties and Responsibilities
- Prioritize incoming authorization and referral requests according to queue urgency
- Review patient’s clinical and chart documentation related to the service submitted by the provider’s office
- Obtain and/or follow up on authorization and referral requests from the patient’s payer/s through any of the following methods—depending on the payer’s policy:
- Perform outbound calls to payer’s authorization department
- Access payer’s authorization online portal
- Submit faxes to payer’s authorization department
- Respond to payer’s clinical questions to be able to proceed with the authorization and referral requests
- Obtain and/or follow up payer’s peer-to-peer review requirements and send them back to provider’s office for the actual initiation
- Cater inbound calls from payers and perform necessary actions required for the task
- Listen and review voicemail messages from payers then perform necessary actions required for the task
- Monitor activities of Nurses to assess schedule adherence, accuracy, quality, productivity, timeliness and compliance with job requirements, policies and procedures. Report updates to management.
- Provide basic on-the-job training for direct reports and serve as a resource to address questions related to the policies, processes and procedures.
- Monitor, identify and resolve performance/behavior/attendance issues using prescribed performance management techniques.
- Adhere to all company policies and procedures.
- Adjust to the needs of meeting service level agreements under supervision of Manager.
- Ensure training needs of team members are met.
- Successfully complete all client related training and keep record of the same.
- Hold team briefings on a daily basis with the team.
- Communicate all process and client changes to direct reports within specific timelines and keep record of such updates.
- Act as a single point of contact for the assigned team members for all their job related needs and create a harmonious work environment.
- Escalate performance related issues with respect to assigned team members to Managers on a timely manner (PIP).
- Responsible for day-to-day functional supervision of work group, including work assignment and attendance monitoring; providing input into selecting, training, developing, and completing performance appraisal of work group(s) in accordance with the organization’s policies and applicable compliance requirements.
- Employee separations to be handled in-line with company policies and HR
Qualifications:
- Active USRN license (any state)
- Active PHRN License
- 3 years of Hospital Experience (ER/OR/Medical Surge)
- Proficiency in MS tools
- 2 years of experience as a Charge Nurse or 1 year BPO Team Lead Experience
- 1 year of experience People Management
- Solid understanding of anatomy & physiology, including how body systems function and an understanding of disease processes
- Comprehensive understanding of Medical Terminology
- Excellent customer service skills: communicates clearly and effectively
- Communicating effectively in writing as appropriate for the needs of the audience
- Professional and effective interaction skills with co-workers, clients, providers, and vendors
- Proven ability to work well individually and as a team member
- Ability to follow company and account-specific standard operating procedures and policies
- Ability to adapt to constantly changing environment
- Ability to prioritize and organize multiple tasks by remaining focused and quality-driven at all tasks at hand & to remain organized with multiple interruptions
- Ability to make decisions independently without bypassing any company and account-specific standard operating procedures and policies
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Team Lead • Pasig, National Capital Region, Philippines
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