Billing Operations Supervisor – Verification Authorization

Job Responsibilities

• Lead and supervise the Verification Authorization team, ensuring accurate and timely insurance verification, prior authorizations, and benefit assessments.
• Develop and monitor team performance metrics, ensuring goals are met for turnaround time, accuracy, and payer compliance.
• Collaborate with payers to resolve eligibility discrepancies, denials, and escalations.
• Work closely with Revenue Cycle leadership to identify trends, gaps, and opportunities for process improvements.
• Implement and update policies and procedures to ensure compliance with regulatory and payer requirements.
• Train, coach, and mentor team members to enhance knowledge of payer guidelines, systems, and best practices.
• Partner with cross-functional teams Billing to support a seamless patient and provider experience.
• Provide regular reporting and analysis of eligibility performance, including KPIs, denial trends, and payer turnaround times.
• Manage staffing schedules, workload distribution, and productivity standards to ensure operational coverage and efficiency.
• Support system implementations, testing, and enhancements related to eligibility processes.
• Provide strategic direction, coaching, and professional development to foster a high-performance culture.
• Lead by example and promote a culture of accountability and continuous improvement.
• Identify and implement process enhancements to improve efficiency, reduce error rates, and support scalability.
• Standardize procedures and documentation across the department.
• Evaluate and implement technology solutions and reporting tools to support automation and performance tracking.
• Ensure adherence to HIPAA, payer rules, and all relevant state and federal regulations.
• Stay current on industry best practices, regulatory updates, and payer changes impacting billing and date of service requirements.

Required Qualifications

• A high school diploma or equivalent required; 5–7 years of experience in healthcare billing operations, with at least 2–3 years in a supervisory or management role.
• Strong knowledge of CPT, ICD-10, HCPCS coding, payer regulations, and revenue cycle management.
• Ability to lead cross-functional initiatives and manage timelines, resources, and deliverables.
• Experience with Medicare Advantage plans and familiarity with Xifin is a plus.
• Demonstrated ability to lead teams, manage change, and drive performance in a fast-paced environment.
• Proficiency in Microsoft Office Suite (Excel, Word, Outlook, Access) and healthcare billing systems.
• Strong interpersonal, communication, and problem-solving skills.

Preferred Qualifications

• Bachelor’s degree in Business, Healthcare Administration, or related field.
• Familiarity with lab workflows and integration with billing systems.
• Experience with Data Analytics Tools.
• Proven ability to lead teams through organizational or system transitions.
• Experience in Precision Medicine or Oncology Billing.
• Focus on service, quality, and continuous improvement.
• Ability to analyze complex issues and develop effective solutions.
• Work effectively across departments to achieve shared goals.
• Understand and exceed internal and external client expectations.
• Thrive in a dynamic environment with evolving priorities.