Billing Supervisor-Prior Authorization and Financial Navigation

Billing Supervisor-Prior Authorization and Financial Navigation New Mexico Cancer Center - 2.8 Albuquerque, NM Job Details Full-time 2 hours ago Benefits Health insurance Dental insurance 401(k) Flexible spending account Paid time off Employee assistance program Vision insurance 401(k) matching Life insurance Qualifications Microsoft Excel Insurance prior authorization Management Healthcare staff management Process improvement ICD-10 Supervising experience Medical billing Productivity software Associate's degree Full Job Description Position Summary The Billing Supervisor, Prior Authorization and Financial Navigation is responsible for overseeing daily operational functions related to insurance verification, prior authorization, and financial navigation across all specialty services. This role ensures timely and accurate authorization of services, effective coordination between clinical, billing, and patient access teams, and proactive financial navigation support for patients throughout the continuum of care. The Supervisor provides leadership, training, and performance management for assigned staff, ensures compliance with payer requirements and regulatory standards, and supports organizational goals related to revenue integrity, patient access, and financial transparency. This position plays a critical role in optimizing reimbursement, minimizing denials and delays in care, and improving the patient's financial experience through compassionate, informed guidance.

ESSENTIAL FUNCTIONS

Reasonable Accommodations Statement:

To perform this job successfully, an individual must be able to perform the essential duties satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. Essential Functions Statement(s): Supervise day‑to‑day billing operations for multiple specialties, including prior authorization, and financial navigation. Monitor workflow to ensure timely prior authorization is completed for services and financial navigation is completed for patients. Collaborate with the Senior Director of Billing Office to develop and implement standardized billing procedures across specialties to maintain consistency and compliance. Oversee patient financial counseling services, ensuring patients receive clear, compassionate, and accurate information regarding insurance coverage, benefits, and out‑of‑pocket responsibilities. Oversee screening and enrollment of patients into appropriate financial assistance programs, including manufacturer assistance, foundations, charity care, and hospital financial assistance policies. Ensure applications are completed accurately and submitted timely. Prior authorization, and financial navigation. Monitor workflow to ensure timely prior authorization is completed for services and financial navigation is completed for patients. Collaborate with the Senior Director of Billing Office to develop and implement standardized billing procedures across specialties to maintain consistency and compliance. Oversee patient financial counseling services, ensuring patients receive clear, compassionate, and accurate information regarding insurance coverage, benefits, and out‑of‑pocket responsibilities. Oversee screening and enrollment of patients into appropriate financial assistance programs, including manufacturer assistance, foundations, charity care, and hospital financial assistance policies. Ensure applications are completed accurately and submitted timely. Analyze prior authorization trends, work with providers on appeals, peer to peers, and ensure collections within financial navigation. Oversee prior authorization and financial navigation processes and implement process improvements, as necessary. Serve as a liaison between billing, and leadership. Serve as a subject‑matter resource for billing staff and escalate complex issues appropriately. Communicate billing issues, trends, and performance metrics to management.

SKILLS & ABILITIES

Education and Experience:

Associate or bachelor's degree in healthcare administration, Business, or related field preferred. 5-7 years of medical billing experience that consists of 3-5 years of prior authorization experience, 3-5 years of financial navigation experience, and with at least 3 years in a supervisory role, required. Experience in multi‑specialty or multi‑provider environments strongly preferred. Expert in manufacturer assistance programs and foundations available for each patient demographic. Expert in prior authorization requirements for a multi-specialty group. Expert with payer portals and insurance policies.

Skills and Competencies:

Strong knowledge of medical billing, CPT/ICD‑10 coding, and payer reimbursement rules. Must be able to read EOB's (Explanation of Benefits). Proficiency with practice management and EHR systems. Excellent leadership, communication, and problem‑solving skills. Ability to analyze data, identify trends, and implement process improvements. Must have advanced computer skills using Microsoft Office Suite (Excel, Word, and PowerPoint) skills. High attention to detail and commitment to accuracy.

Benefits:

401(k) 401(k) matching Dental insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Vision insurance

Work Location:

In person