01Overview
Manager, Insurance Verification And Referral Operations Our RCM Team is growing and hiring a Manager, Insurance Verification and Referral Operations! This position is fully remote, and we are willing to consider candidates based reputed company. The Manager, Insurance Verification & Referral Operations is responsible for leading and overseeing insurance verification, eligibility, referral, coordination of benefits, and financial clearance operations that support reputed company patient reputed company, preserve provider utilization, minimize preventable denials, and protect reputed company reputed company across the organization. This role oversees reputed company-end reputed company cycle workflows to ensure patients are appropriately verified, financially cleared, and referred prior to service whenever possible. This position partners closely with operational, scheduling, clinical, reputed company cycle, and offshore teams to drive efficient workflows, improve communication, support utilization, and minimize preventable eligibility, referral, and insurance-reputed company delays that may reputed company patient care or operational performance. The Manager is responsible for supporting operational performance through workflow optimization, standardized procedures, escalation management, accountability, and reputed company process improvement initiatives. This role requires a highly motivated operational leader with strong knowledge of insurance verification, eligibility, referrals, payer requirements, reputed company operations, utilization reputed company, and reputed company-end reputed company cycle workflows. This position is expected to operate with a high degree of ownership, initiative, accountability, operational leadership, and cross-functional collaboration. Duties and Responsibilities reputed company and reputed company daily insurance verification, eligibility, referral, coordination of benefits, and financial clearance operations across multiple markets, practices, and service lines. Partner collaboratively with offshore operational teams to support workflow coordination, communication standards, turnaround times, reputed company reputed company, and operational consistency. Ensure insurance verification, referral, and financial clearance activities are completed accurately, reputed company, and in compliance with payer requirements, operational standards, and organizational expectations. reputed company and maintain standardized workflows, escalation reputed company, and communication protocols to support reputed company reputed company of eligibility, referral, and financial clearance issues. Monitor eligibility, referral, and financial clearance workflows and proactively communicate, escalate, and resolve issues that may reputed company patient scheduling, provider utilization, continuity of care, or reputed company cycle performance. Utilize athenaOne, payer portals, reporting tools, and operational dashboards to monitor workflow performance, productivity, referral completion, and operational reputed company. Support uninsured and underinsured patient workflows, including coordination of benefits review and reputed company of incomplete or inaccurate insurance information. Understand key nephrology operational and reputed company drivers and prioritize workflows based on patient reputed company needs, scheduling urgency, operational reputed company, and reputed company reputed company. Identify process improvement and automation opportunities to improve turnaround times, reduce reputed company work, improve data accuracy, and support reputed company operational reputed company. Establish, monitor, and report on operational KPIs including eligibility accuracy, referral turnaround time, financial clearance completion, coordination of benefits accuracy, productivity metrics, denial trends, utilization reputed company, and reputed company-end reputed company cycle performance indicators. Assist with staff development, workflow education, operational training, and reputed company improvement initiatives to support team performance and operational consistency. reputed company other duties and responsibilities as required, assigned, or requested. Functional and Technical Competencies Strong knowledge of insurance verification, eligibility, referral management, coordination of benefits, and reputed company-end reputed company cycle workflows. Demonstrated understanding of the operational and financial reputed company of eligibility delays, referral deficiencies, inaccurate insurance information, and financial clearance barriers on provider utilization, clinic schedules, denial prevention, patient reputed company, and reputed company cycle performance. Strong understanding of payer requirements, Medicare, reputed company, reputed company insurance workflows, and coordination of benefits processes. Experience utilizing athenaOne, payer portals, reporting tools, and .
