Insurance Verification Manager

Company Description

Heart & Vascular Partners LLC (“HVP” or the “Company”) is a leading, national management services organization built exclusively to support independent cardiology and vascular practices and their physician partners.  HVP was founded by clinicians, for clinicians, to provide specialized supported services to meet the needs of cardiovascular care, including managed care contracting, facility development and operations, revenue cycle management, and marketing to both patients and referral partners. 

HVP serves its partners through a national and scaled service delivery platform.  The Company remains active in expanding its impact through the leading practices in the markets it targets for investment.  Bringing together the most innovative, successful, independent cardiovascular clinicians across the country delivers unique insight, scale, and acceleration of realizing the potential value of each practice for its community, partners, and team members.  

Role Summary

The Insurance Verification Manager is responsible for overseeing the insurance verification team, ensuring accurate and timely verification of patient insurance coverage, eligibility, and benefits. This position involves managing a team of insurance verification specialists, optimizing workflows, implementing best practices, and ensuring compliance with healthcare regulations. The Insurance Verification Manager will also collaborate with other departments, such as billing and finance, to streamline processes and minimize claim denials.

Essential Responsibilities: 

• Manage, train, and mentor a team of insurance verification specialists, providing guidance, support, and performance evaluations.
• Develop and implement strategies to enhance the efficiency and accuracy of insurance verification processes, ensuring timely and accurate verification of insurance benefits.
• Monitor the accuracy of insurance verifications performed by team members, reviewing documentation and ensuring compliance with insurance guidelines and company policies.
• Work closely with other departments (e.g., billing, coding, patient services) to resolve issues related to insurance verification and pre-authorization.
• Provide ongoing training to the team on new insurance procedures, regulations, and system updates to ensure a high level of proficiency.
• Generate and analyze reports on insurance verification metrics (e.g., verification turnaround time, denial rates) to assess team performance and identify areas for improvement.
• Address and resolve complex insurance verification issues, working with insurance companies and healthcare providers to ensure accurate information is obtained.
• Ensure all verification processes adhere to healthcare regulations, including HIPAA, and company policies regarding patient privacy and data security.
• Oversee the process of obtaining pre-authorizations, referrals, and verifying eligibility for medical services and treatments as required by insurance providers.
• Ensure a high level of customer service when interacting with patients and insurance representatives, providing clear and accurate information regarding coverage and patient responsibilities.
• Stay updated on the latest industry technology, systems, and trends related to insurance verification and leverage them to improve the team’s performance.

Minimum Requirements, Skills & Education: 

• Bachelor’s degree in healthcare administration, business, or a related field; or equivalent work experience.
• Minimum of 3-5 years of experience in insurance verification, medical billing, or a related field, with at least 2 years in a supervisory or managerial role.
• Strong leadership and team management skills.
• Excellent communication and interpersonal skills, both written and verbal.
• Advanced knowledge of insurance verification processes, healthcare insurance terminology, billing codes, and medical terminology.
• Experience with insurance verification systems, Electronic Health Records (EHR), and office software (e.g., MS Office).
• Strong analytical skills with the ability to interpret data and generate reports.
• Knowledge of healthcare compliance, including HIPAA and insurance regulations.
• Certification in medical billing or coding (e.g., CPC, CBCS) is a plus.

Work Environment:  

This role is a Remote role that requires a reliable high-speed internet connection. While working remotely, the Insurance Verification Manager will oversee a team of specialists, ensuring effective communication, collaboration, and productivity through online platforms and tools. Regular check-ins, team meetings, and performance evaluations will be conducted remotely. Regular virtual communication via video conferences, phone calls, and emails with the team, management, and other departments. 

Due to the nature of the job, adherence to security protocols for remote work (such as VPN usage, secure file storage, and data protection practices) is critical to ensuring HIPAA compliance and safeguarding patient information.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to see, talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. This position requires the ability occasionally to lift files, office products and supplies, up to 20 pounds.  This position is primarily a desk position, requiring sitting longer hours at the computer typing on a keyboard.

Salary and Benefits

Full-time, exempt position. Competitive compensation and benefits package to include 401K; a full suite of medical, dental, and ancillary benefits; paid time off, and much more. 

Equal Employment Opportunity Statement

Heart and Vascular Partners provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.  This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.