Insurance Operations Coordinator

Job Overview

We are seeking a skilled and experienced professional to oversee our customer service operations. The Insurance Verification Supervisor will play a key role in ensuring the efficient and accurate verification of patient insurance coverage and authorizations.

This is an excellent opportunity for someone who is passionate about delivering exceptional customer service and has a strong background in healthcare operations or revenue cycle management.

The successful candidate will have outstanding leadership, communication, and interpersonal skills, with the ability to influence and collaborate effectively with cross-functional teams.

They will be responsible for providing direct supervision to a team of insurance verification specialists, supporting their development and ensuring adherence to established procedures and standards.

The supervisor will also be responsible for assisting in the development and implementation of standardized procedures for insurance verification, overseeing and participating in the verification of patient insurance coverage, and communicating with insurance companies to obtain authorizations and resolve authorization-related issues.

Key responsibilities include:

• Supervising and supporting a team of insurance verification specialists;
• Providing training, coaching, and mentorship to team members to enhance their skills and performance;
• Fostering a collaborative and positive work environment conducive to achieving team goals;
• Assisting in the development and implementation of standardized procedures for insurance verification;
• Overseeing and participating in the verification of patient insurance coverage, ensuring accuracy and timeliness;
• Supporting team members in resolving insurance-related inquiries and discrepancies;
• Assisting in coordinating the authorization process for medical procedures and services requiring pre-authorization;
• Communicating with insurance companies to obtain authorizations and resolve authorization-related issues;
• Monitors authorization status and escalates issues as necessary to ensure timely approvals;
• Collaborates with billing and coding teams to address insurance-related claim rejections and denials;
• Assists in investigating and resolving discrepancies in insurance coverage and billing information;
• Provides guidance to team members on optimizing claim submission and reimbursement processes;
• Conducts regular training sessions and provides ongoing support to ensure team members are proficient in insurance verification procedures and software;
• Identifies training needs and opportunities for professional development among team members;
• Encourages continuous learning and skill enhancement within the team;
• Ensures compliance with HIPAA regulations and other relevant healthcare laws and regulations;
• Conducts periodic audits of insurance verification processes to ensure accuracy and compliance;
• Collaborates with the Insurance Verification Manager to implement improvements and address areas for enhancement;
• Embraces and exemplifies the Cardinal Health values: Invites Curiosity, Builds Partnerships, Inspires Commitment, Develops Self and Others;
• May perform any additional responsibilities or special projects as required;
• May provide cross-functional support as business needs demand.

Requirements

Internal candidates must meet the following requirements:

• No disciplinary actions for the past 12 months;
• At least 1 year of tenure in current role;
• Knowledge in Healthcare Operations or Revenue Cycle Components is required (Any of the following: Insurance Verification, Medical Documentation, Prior Authorization, or Revenue Cycle Management).

External candidates must meet the following requirements:

• At least 2 years of college coursework or experience;
• 2 years of Leadership experience;
• Knowledge in Healthcare Operations or Revenue Cycle Components is required (Any of the following: Insurance Verification, Medical Documentation, Prior Authorization, or Revenue Cycle Management);
• Experience in using Contact Center phone system such as NICE and/or Genesys is an advantage.

Competencies

• Professional and effective communications skills; able to calmly present solutions in challenging situations;
• Proactive identification of challenges and solution-oriented approach to problem solving;
• Service orientation and aptitude to utilize proper listening skills;
• Effective analytical skills: able to use inductive and deductive reasoning to anticipate outcomes;
• Self-directed accountability and reliability;
• Effective leadership, communication, and interpersonal skills with the ability to influence and collaborate effectively with cross-functional teams;
• Able to manage and prioritize multiple tasks/projects, work autonomously, and meet deadlines;
• Able to work well in a team environment that promotes inclusiveness and communication among team members;
• Communication using both verbal and written English proficiency.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience, and background.