Manager, Insurance Coordinators

Summit Spine and Joint Centers•Lawrenceville, GA

About The Position

We are seeking a highly motivated and experienced Manager of Insurance Verification and Authorization to lead and mentor our team of insurance coordinators. The successful candidate will oversee the daily operations of both Insurance Verification and Insurance Authorization Specialists, ensuring efficient, accurate, and timely processing of patient insurance information. This role requires a leader with strong problem-solving skills and in-depth knowledge of the healthcare revenue cycle. This job is a full-time, benefited position at Summit Spine & Joint Centers that reports to the Administrative Operations Director.

Requirements

Must be personable and detail oriented as a representative of the practice while callers rely on proper information.
Excellent verbal and written skills for proper documentation of encounters.
Minimum of 4 years' experience in an outpatient medical office, working in an Insurance Verification/Authorization.
Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required
Authorization portal experience required
Experience in Pain Management Authorizations required
EMR/EHR experience is required.

Nice To Haves

Experience as a manager of Insurance Coordination preferred

Responsibilities

Team Management: Manage, train, and mentor a team of Insurance Verification and Authorization Specialists, fostering a culture of teamwork, high performance, and continuous improvement.
Operational Oversight: Develop, implement, and monitor workflows and protocols for all insurance verification, authorization, and referral processes to maximize efficiency and accuracy.
Performance Monitoring: Set and track key performance indicators (KPIs) for the team, including authorization success rates, denial rates, and turnaround times. Provide regular reports to senior management.
Escalation Management: Serve as the primary point of contact for resolving complex insurance issues, discrepancies, and difficult authorization cases.
Quality Assurance: Conduct regular audits of patient accounts to ensure all information, including eligibility, benefits, and pre-authorizations, is accurately documented.
Carrier Relations: Maintain effective communication and build strong relationships with various insurance carriers and third-party payers.
Compliance: Ensure the team's strict adherence to all internal policies, as well as state and federal regulations, including HIPAA.
Training & Development: Identify training needs and organize ongoing education for the team on new insurance policies, procedures, and software systems.
Process Improvement: Identify and implement opportunities for process improvements and system enhancements to streamline the verification and authorization process.
Other Insurance duties as assigned