Insurance Operations Manager
Insurance Operations Manager
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Job Description
Overview
Ignite your passion and make a difference at KidsCare! At KidsCare Home Health were more than just a healthcare provider were a community of compassionate professionals changing lives every day. As a multiawardwinning organization and proud recipient of the 2024 U.S. Top Workplace award were looking for enthusiastic individuals who are ready to grow connect and make a meaningful impact.
Responsibilities
The Insurance Operations Manager oversees the daily operations and performance of insurance authorization activities. The position provides guidance coaching and support for optimal employee success and has on going knowledge of each states policies and procedures works with multiple payer sources and obtains insurance authorization for physician ordered services. The position is also responsible for monitoring and recertifying patient insurance authorization prior to the current expiration date.
Key Duties and Responsibilities
Monitor and ensure compliance with payer authorization requirements acting as a knowledgeable resource.
Track key performance indicators and identify utilization trends.
Generate and review reports (e.g. recertifications denials authorizations due).
Evaluate and improve workflow processes for efficiency and quality.
Supervise support and provide feedback to team members.
Conduct team meetings and maintain open communication.
Manage schedules time off training and staff coverage using ADP.
Oversee onboarding and ongoing training of staff.
Maintain updated payer guidelines and departmental checklists.
Foster strong internal and external working relationships.
Support Therapy Operations Coordinator as needed.
Ensure compliance with company policies and assist with other tasks as assigned.
Qualifications
Qualifications and Skills:
- Bachelors Degree in Business Healthcare Administration or related field . A combination of education and experience may substitute.
- Two (2) Five (5) years of experience in Healthcare Administration preferred.
- Ability to lead teams manage and measure performance and drive operational success is essential.
- Proficient in Excel including experience with data filtering conditional formatting and data extraction.
- Proven experience with multiple Electronic Medical Record systems and familiarity with a variety of insurance portals.
Physical Demands/Working Environment
- Ability to sit at a computer for an extended period.
- Light to moderate physical activity and lifting required.
- Specific vision abilities required include close vision.
- Moderate noise level (i.e. business office with computers phone and printers light traffic).
INDA
Required Experience:
Manager
Employment Type
Full-Time
