Medical Billing & Prior Authorization Team Lead

The Medical Billing & Prior Authorization Team Lead oversees daily revenue cycle operations, leading a team of specialists responsible for insurance verification, prior authorizations, referrals, medical billing, and patient financial services. This role ensures accurate and timely processing, compliance with payer requirements and HIPAA regulations, and adherence to operational standards. Key responsibilities include supervising team performance, providing training, coaching, and quality oversight, resolving complex insurance-related escalations, monitoring productivity, and driving continuous process improvements. The role also collaborates closely with management, healthcare providers, scheduling teams, and other revenue cycle stakeholders to ensure efficient operations and high-quality service delivery.

Job Description

• Lead, train, onboard, and mentor new and existing team members to ensure successful performance and adherence to company standards

• Monitor daily workflows, productivity, quality, and service levels to meet operational goals and client expectations

• Conduct regular coaching sessions, performance reviews, and quality audits to identify strengths and opportunities for improvement

• Serve as the primary escalation point for complex billing, insurance, and patient account issues

• Foster a collaborative, accountable, and positive team culture focused on continuous improvement and excellence

• Assist management in workforce planning, scheduling, and resource allocation

• Monitor team performance through established KPIs,



including productivity, quality, turnaround times, authorization success rates, and reimbursement outcomes

• Maintain and update payer reference guides, workflows, and standard operating procedures

• Identify process inefficiencies and implement solutions to improve operational effectiveness and financial outcomes

• Ensure compliance with HIPAA regulations, payer requirements, and organizational policies

• Generate reports and provide performance insights to leadership to support decision-making

• Participate in team meetings, departmental initiatives, and special projects

• Provide prompt responses to inquiries from patients, providers, scheduling teams, and revenue cycle staff

Requirements & Qualifications

- High school diploma or equivalent required.
- Minimum of 3 years of experience in U.S. healthcare revenue cycle management (RCM), including medical billing, insurance verification, prior authorizations, referrals, or related functions.
- Minimum of 1 year of leadership, supervisory, team lead, SME, or coaching experience.
- Strong knowledge of U.S. medical billing processes, insurance verification, prior authorizations, referrals, and revenue cycle operations.
- Experience handling copays, coinsurance, deductibles, patient responsibility calculations, and Good Faith Estimates.
- Proven experience working with eClinicalWorks (eCW), practice management systems, EHRs, and Microsoft Office applications.
- Strong organizational, problem-solving, communication, and team management skills.
- Stable employment history.

📌 Medical Billing & Prior Authorization Team Lead (Bogotá)
🏢 Connext
📍 Bogotá