Insurance Verification Manager

This role is responsible for supervising, planning, directing and overseeing the Insurance Verification division of the organization, providing feedback to improve efficiency and effectiveness. Also responsible for improvement of order to cash process and reduction of bad debt.

Major Areas of Accountability

• Meeting Financial performance and revenue growth goals while managing the operations of the revenue cycle management department.
• Establish systems and processes which result in patient satisfaction, employee engagement, and financial performance.
• Oversee teams (and maximize team members' capabilities) of existing and new team members, ensuring they are fulfilling responsibilities and KPI's, meeting job requirements, and producing expected or exceeding results on RCM collection targets.
• Provides supervision, oversight, and direction to the insurance verification specialists, including, but not limited to, assignment allocation, training, employee motivation, and work performance evaluations.
• Hiring and onboarding of new team members, overseeing time off requests and timesheets, and ensuring adequate coverage during business hours.
• Review and create work queues and workflows for the Insurance Verification Specialists.
• Create new and review current policies and procedures, recommend areas of improvement to Eligibility and Benefits workflows, and coordinate with Revenue Cycle Management leadership to implement changes as required.
• Ensure that the activities of the verification and authorization operations are conducted in a manner that is consistent with overall department protocol and in compliance with Federal, State, and payer regulations, guidelines, and requirements.
• Provide, oversee, and/or coordinate training for new and existing staff on workflows, policies, procedures, rules, regulations, etc.
• Review monthly denials related to insurance verification and, under the guidance of the take appropriate actions to eliminate insurance benefit-related denials.
• Assigns and delegates tasks as needed in the absence of employees, so workflow is maintained
• Facilitates and communicates necessary changes to appropriate department leadership to improve processes.
• Maintains up to date working knowledge of latest healthcare trends in authorization, insurance verification and benefits, reimbursement, and claims denials.
• Conduct research necessary to update reference materials
• Manage all functions pertaining to the order release concerning insurance verifications: qualifying services with verification of benefits, pre-authorizations, and financial review.
• Accomplish results by communicating expectations, planning and properly coaching team members within the insurance verification area
• Ensure quality of work and organization, reviewing and monitoring insurance applications and insurance payer agreements following company policies and standards
• Maintain compliance with the Health Insurance Portability and Accountability Act (HIPAA) for all work
• Adhere to company policies and procedures with an emphasis on professional behavior
• Assist with other duties as required
• Comfort Medical employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.
• Other job duties as assigned

Basic Qualifications

• Bachelor's Degree preferable in business or equivalent of 10 years direct related experience in healthcare field.5 years Knowledge of Benefits and Verification coverages
• 3-5 years of Managerial experience
• DME industry experience strongly preferred
• Proficient in Excel and Word
• Excellent oral and written communication skills
• Excellent organizational skills
• Ability to take initiative and work independently
• Comfort Medical employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.

At Coloplast, we believe in recognizing and rewarding the contributions of our employees. Our total rewards package is designed to support your well-being, foster your professional growth, and ensure a healthy work-life balance. Here is some of what you can expect:

• Health and Wellness: Comprehensive medical, dental, and vision insurance plans to keep you and your family healthy. Plus, access to company sponsored wellness programs and mental health resources, paid leave of absence for qualifying events and generous paid parental leave for both birthing and non-birthing parents.
• Financial Security: A competitive 401(k) plan with company match that vest immediately, financial planning services to help you secure your future, and corporate discount programs for goods and services.
• Work-Life Balance: Generous paid time off, flexible work hours, and flexible work arrangement options to help you balance your personal and professional life may be available.
• Professional Development: Opportunities for continuous learning and career advancement through training programs, mentorship, and tuition reimbursement.
• Recognition and Rewards: Recognition programs to celebrate achievements and contributions, including peer recognition, bonuses, awards, and special events.
• Community and Culture: A supportive work environment where everyone feels valued and has a sense of belonging. Participate in team-building activities, volunteer opportunities, and company-sponsored events. Sustainability strategy that outlines our ambitions for how to run our company in a more sustainable way.
• Competitive Compensation: The compensation range for this position is $92,595 - $138,893. Actual compensation is influenced by a variety of factors including but not limited to skills, experience, qualifications, and geographic location. Hired candidates may be eligible to receive additional compensation in the form of bonuses and/or incentives.

Comfort Medical provides an extensive selection of name brand catheter and ostomy supplies to thousands of customers nationwide. Our attention to detail, unmatched customer service, and dedication to helping our customers live happier, healthier lives are just a few of the many reasons we are one of the fastest growing catheter and ostomy supply companies in the nation!

Comfort Medical employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.

Comfort Medical is committed to a policy of Equal Employment Opportunity (EEO) which means we employ and promote individuals based on their merits, regardless of race, color, religion, sex, national origin, age, disability, veteran status, pregnancy, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status, status with regards to public assistance or any other protected classification.

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