Senior Manager Reimbursement Operations

Job Summary

A company is looking for a Senior Manager, Reimbursement Operations to lead reimbursement operations functions.

Key Responsibilities

• Oversee Prior Authorization, Eligibility, and Insurance Discovery teams for efficient processing
• Develop strategies to improve prior authorization approval rates and reduce denials
• Manage appeals and claims follow-up processes to maximize successful outcomes

Required Qualifications

• Bachelor's degree with 12+ years of experience in healthcare reimbursement operations
• At least 5 years in a management role, preferably in the CLIA laboratory services or oncology sectors
• Extensive experience with billing, prior authorization, and appeals processes
• Strong understanding of medical billing and coding, including ICD-10 and CPT codes
• Proficiency in data analysis to drive process improvements