Patient and Insurance Eligibility Supervisor

Southeast Alaska Regional Health Consortium•Juneau, AK

50d•$29 - $41

About The Position

SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement. Working at SEARHC is more than a job, it's a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health, dental, and vision benefits, life insurance and long and short-term disability, and more. Key Essential Functions and Accountabilities of the Job Supervise and coordinate the activities of the Pre-Access teams, including collaboration with external departmental staff assigned to specific disciplines for processing referrals and scheduling. This role serves as a point of contact for vendor management supporting Insurance Verification, Authorizations, and Patient Health Benefits. The Supervisor ensures productivity and quality standards are consistently met across all functions. Monitor referral and authorization workflows to ensure timely acknowledgment, submission, and follow-up on pending requests. Serve as a subject matter expert on payer authorization requirements, regularly communicating updates to staff. Collaborate closely with scheduling, billing, third party vendors, and clinical departments to resolve authorization-related issues, and coordinate with Utilization Review (UR) to ensure medical necessity and appropriateness, helping to prevent claim denials. Provide leadership and support to the Pre-Access teams through training, mentoring, performance evaluation, and ongoing coaching to promote professional development and operational excellence. Assist in hiring and onboarding new team members, ensuring alignment with the organization's Mission, Core Values, and Vision. Assist in developing and maintaining standard operating procedures (SOPs) for Pre-Access processes, ensuring compliance with HIPAA and other regulatory requirements. Generate and analyze performance reports to monitor team productivity, identify trends, and recommend process improvements. Participate in audits and implement corrective actions as needed to maintain compliance and operational excellence. Supports vendor management activities by monitoring performance against service level agreements (SLAs), communicating expectations and feedback, assisting in the evaluation and selection of third-party authorization service providers upon request, and collaborating with vendors to resolve issues timely and enhance service delivery.

Requirements

2 years' healthcare experience, with at least 1 year in a supervisory or lead capacity.
Knowledge of specialty billing; including but not limited to Optometry, Audiology, Home Health, Dental, etc.
Knowledge of IHS and non-IHS. Federal rules and regulations regarding hospital and outpatient billing.
Knowledge of technology and optimization for Insurance Verification Workflows.
Knowledge of Patient Access, Customer Service, Referrals, Authorizations.
Knowledge of private and governmental billing policies and practices to ensure compliance.
Knowledge of insurance claim forms including but not limited to Veterans Affairs.
Knowledge of ICD-10, CPT, HCPCS Level II Codes.
Knowledge of Medical Terminology.
Maintain up to date education and knowledge of Revenue Cycle Operations.
Proficient using a keyboard and 10 key.
Proficient in Microsoft Office programs (i.e. excel, word)
Highly motivated, self-starter.
Attention to detail and accuracy.
Good organizational skills.
Good oral and written communication skills.
Problem solving and decision-making skills.
Ability to multitask.
Ability to work in a fast-paced setting.
Ability to collaborate within cross-functional teams.
Excellent communication and interpersonal skills
Strong organizational & time management abilities
Teamwork
Proficient in EHR systems