Job Purpose
The Manager, Insurance Operations is responsible for overseeing day-to-day insurance follow-up and billing patient account processing activities. The Manager, Insurance Operations will lead operational teams, monitor performance and quality, support client needs, and ensure effective execution of processes and best practices to achieve revenue cycle and client objectives.
Duties & Responsibilities
- Oversee day-to-day insurance follow-up and billing operations to ensure performance, productivity, and quality objectives are achieved
- Manage and develop operational teams responsible for client delivery, ensuring consistent adherence to established standards and processes
- Monitor operational performance metrics and identify trends, gaps, and opportunities for improvement
- Implement and maintain effective operational processes and best practices for insurance follow-up, billing, and receivables management
- Partner with leadership and client teams to address operational issues, improve performance, and support client objectives
- Monitor client service delivery and maintain strong working relationships with client contacts
- Support the development and execution of operational plans and initiatives aligned with organizational and client goals
- Ensure appropriate staffing and resource allocation to meet operational and client requirements
- Identify opportunities to improve productivity, efficiency, quality, and financial performance
- Prepare and communicate operational reports, performance results, and recommendations to leadership and clients as appropriate
- Ensure quality standards are understood, consistently followed, and monitored across assigned operations
- Other duties as assigned
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Understand and comply with Information Security and HIPAA policies and procedures at all times
- Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Qualifications
- Bachelor’s degree in a business-related field required
- 5+ years of experience in hospital revenue cycle operations, insurance follow-up, billing, or receivables management
- 3+ years of experience managing or supervising revenue cycle teams
- Experience managing third-party insurance accounts receivable and follow-up operations
- Demonstrated ability to monitor operational performance, analyze results, and implement process improvements
- Experience developing and maintaining operational reports, metrics, and performance dashboards
- Strong understanding of insurance billing, follow-up, and accounts receivable best practices
- Demonstrated ability to lead teams and achieve operational, quality, and productivity objectives
- Ability to effectively manage competing priorities and drive operational improvements
- Ability to implement and promote change and innovation
- Proficiency in Microsoft Office Suite
- Strong interpersonal skills, ability to communicate well at all levels of the organization
- Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
Working Conditions
- Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress
- Work Environment: The noise level in the work environment is usually minimal
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
