Insurance Operations Manager

Job Summary

A company is looking for a Manager, Insurance Operations to oversee the insurance lifecycle and enhance the member experience.

Key Responsibilities

• Design and manage the verification of benefits workflow to ensure accurate payer coverage
• Optimize prior authorization workflows and analyze rejection patterns to improve processes
• Oversee member billing processes and manage external vendors involved in insurance issues

Required Qualifications

• 3-5+ years of experience in healthcare operations, insurance operations, or revenue cycle
• Strong understanding of insurance eligibility, benefits verification, and prior authorization workflows
• Experience partnering with RCM and managing vendor performance
• Proven ability to manage and improve operational workflows
• Familiarity with EMRs, Practice Management solutions, and BI tools