Authorization​/Eligibility Team Lead

Cardiovascular Physicians of Delaware

Position Title:

Authorization/Eligibility Team Lead

Location:

Remote

Who we are:

Cardiovascular Physicians of Delaware seeks to redefine high-quality specialty care in the United States and establish a high-performing, technology-enabled care delivery platform. Cardiovascular Physicians of Delaware is partnering with the country’s leading physicians to build a comprehensive, out-patient focused specialty care network targeting the nation’s cardiovascular concerns. Our physician-led organization is passionate about supporting exceptional care and enriching the lives of patients across the United States.

We envision the opportunity to create a scaled, cutting-edge, technology-enabled healthcare services platform that leverages a value-based delivery model.

The Authorization/Eligibility Team Lead oversees the daily operations of a team responsible for verifying patient insurance coverage, determining eligibility for services, and obtaining prior authorizations to ensure timely access to care. This role provides leadership, training, and support to team members while monitoring productivity, accuracy, and compliance with insurance requirements and organizational policies. The Team Lead works closely with insurance companies, healthcare providers, and internal departments to resolve authorization issues, reduce claim denials, improve workflows, and ensure efficient revenue cycle operations while maintaining excellent customer service and patient satisfaction.

• -Oversee daily operations of the Authorization/Eligibility team, assign workloads, monitor performance, and ensure team members meet productivity and quality standards.
• -Ensure patient insurance coverage, benefits, plan limitations, deductibles, copayments, and out-of-pocket responsibilities are verified accurately and timely.
• -Oversee the submission, tracking, and follow-up of prior authorization requests to ensure services, procedures, or treatments are approved before scheduled appointments.
• -Monitor daily work queues, prioritize urgent requests, manage pending authorizations, and ensure tasks are completed within established turnaround times.
• -Train new employees, provide ongoing coaching, communicate policy updates, and support staff in improving accuracy, efficiency, and customer service.
• -Resolve complex eligibility discrepancies, authorization denials, delayed approvals, and insurance-related issues by collaborating with insurance representatives, providers, and internal departments.
• -Track key performance indicators, including productivity, authorization turnaround times, verification accuracy, pending requests, and denial trends. Prepare reports and recommend improvements.
• -Work closely with scheduling, registration, billing, coding, clinical teams, and revenue cycle management to prevent delays in care and reduce claim denials.
• -Communicate changes in insurance policies, authorization requirements, payer portals, and eligibility procedures to ensure the team remains informed and compliant.
• -Assist with staffing coverage, schedule coordination, workload distribution, and attendance monitoring to maintain consistent departmental operations.
• -Identify authorization and eligibility issues that could result in claim denials or delayed reimbursement and implement corrective actions to minimize financial impact.

Reports to the Billing Manager. Provides day-to-day leadership, workload assignment, training, coaching, and performance oversight for the Authorization/Eligibility team.

• -High school diploma or equivalent

• -Knowledge of medical billing and coding
• -Knowledge of Utilization Management sites (i.e., eviCore, AIM, RadMD, Navinet)
• -Proficient with Next Gen Practice Management and EHR
• -Excellent verbal and written communication skills
• -Excellent interpersonal and customer service skills
• -Excellent organizational skills and attention to detail
• -Excellent time management skills with a proven ability to meet deadlines
• -Ability to prioritize tasks and to delegate them when appropriate
• -Ability to function well in a high-paced and at times stressful environment
• -Provides exceptional customer service to our patients
• -Always exhibits professionalism and ethical behavior
• -Maintains strict confidentiality of patient and business information
• -Maintains OSHA and HIPAA regulations
• -Works as part of the team and treats everyone with respect, courtesy, and…