Senior Manager, Insurance Verification

Job Purpose

Manages the day to day operations of infusion insurance verification process to financially clear patients for upcoming services. Works with Clinical Departments and PBS leadership to create efficient and progressive workflows. Mentors and monitors Supervisors of Insurance verification.

Job Duties
  • Manages the insurance verification process to verify medical benefits and financial clearance of patients.
  • Evaluates workflow while developing plans to meet service level agreements with departments.
  • Manages and mentors supervisors and insurance verification staff.
  • Identifies issues and implements change for quality improvement Interviews, hires, disciplines, completes performance evaluations and provides guidance and feedback to employees.
  • Works with HR and regulatory compliance on complex employee issues.
  • Reviews, understands, and communicates payer industry standards and changes.
  • If needed implements those changes in collaboration with IT, updating Epic as needed Ensures policies and procedures are understood and followed by supervisors, and assures communication to front line staff.
  • Sets goals and objectives for supervisors and employees.
  • Analyzes patient WQ's to find trend issues and works with appropriate departments such as IT, to bring issues to resolution.
  • Requests, designs and reviews reports for trends and researches denials related to insurance verification.
  • Works with senior leadership to develop budget, and has accountability to the area to work within budget constraints.
  • Works with 3rd party vendors to assure their programs are working to benefit the area and that there is a good return on investment.
  • Analyzes trends and issues and works directly with affected departments to bring issue to resolution.
  • Works complex projects as assigned.
  • Attends and participates leadership meetings as requested.
  • Works with Project managers, giving operational guidance on special projects within the clinical departments.

Minimum Qualifications
  • Bachelor's degree in a related field.
  • Five years of insurance verification management/supervisory experience.

Preferred Qualifications
  • Team lead, supervisor or manager of specialty verification and authorization submission experience a plus.

Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.


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