Revenue Cycle Insurance Manager

Human Services Management Corporation•Milford, MA

1d•Hybrid

About The Position

The Revenue Cycle Insurance Manager reports directly to the Director of Revenue Cycle. This is a hybrid position with a minimum of three days in the office (eligible after 90 days of regular employment). The role involves supervising, training, mentoring, and evaluating insurance coordinators and intake staff, monitoring daily workflows for accuracy, compliance, and timeliness, and tracking staff performance. The manager will oversee insurance verification, benefit coordination, patient eligibility, and member responsibility, ensuring appropriate authorizations, referrals, pre-certifications, and re-verifications are obtained. This includes performing and supporting the intake of patient referrals and overseeing all functions necessary for accurate and timely billing related to authorizations. The position also ensures the delivery of complete and accurate intake and insurance information to billing systems, assists with insurance and payer billing processes, denials, eligibility issues, and benefits-related inquiries. Additionally, the role requires ensuring all required documentation is present, accurate, and maintained within patient files, documenting correspondence, and maintaining insurance contacts, authorization tracking, and policy effective/termination dates. The manager will also create, monitor, and maintain operational and performance reports, monitor benchmarks, identify operational risks or trends, and function as a technical specialist for appeals, including payer rules and contractual guidelines. Finally, the role involves acting as a resource to staff, internal departments, and client companies regarding insurance and intake processes, and resolving patient and payer issues in a timely and professional manner.

Requirements

Minimum of five (5) years of experience related to client intake, insurance verification, authorization processing, medical billing, and collections
Minimum of three (3) years of supervisory or team lead experience
Ability to express or exchange ideas clearly and accurately through spoken and written communication

Nice To Haves

Bachelor’s Degree preferred

Responsibilities

Supervise, train, mentor, and evaluate insurance coordinators and intake staff
Monitor daily workflows to ensure accuracy, compliance, and timeliness
Track staff performance, assign work, and address service interruptions
Oversee insurance verification, benefit coordination, patient eligibility, and member responsibility (co‑pays, deductibles, lifetime caps)
Ensure appropriate authorizations, referrals, pre‑certifications, and re‑verifications are obtained and maintained
Perform and support intake of patient referrals including demographic, medical, therapy, and insurance information
Oversee all functions necessary for accurate and timely billing as they relate to authorizations
Ensure delivery of complete and accurate intake and insurance information to billing systems
Assist with insurance and payer billing processes, denials, eligibility issues, and benefits-related inquiries
Ensure all required documentation is present, accurate, and maintained within patient files
Document all correspondence with insurance carriers, patients, and client companies
Maintain insurance contacts, authorization tracking, and policy effective/termination dates
Create, monitor, and maintain operational and performance reports
Monitor benchmarks and identify operational risks or trends
Function as technical specialist for appeals, including payer rules and contractual guidelines
Act as a resource to staff, internal departments, and client companies regarding insurance and intake processes
Resolve patient and payer issues in a timely and professional manner