Eligibility & Benefits Verification Supervisor

Position Overview

The Supervisor, Eligibility & Benefits Verification is responsible for overseeing the daily operations of the eligibility and benefits verification team, ensuring accurate and timely verification of insurance coverage, copays, deductibles, out-of-pocket expenses, and cost estimates for new and established patients across all payer types.

Essential Responsibilities

• Manages and develops an effective staff: providing effective communication, leadership, guidance, and resources according to organizational policies and applicable laws and regulations.

• Determines staff qualifications and competency: recruits, interviews, selects, hires, trains, orients, mentors, evaluates, coaches, counsels, disciplines, and rewards.

• Establishes and monitors staff safety and regulatory compliance.

• Oversees the day-to-day workflow of the eligibility and benefits verification team, assigning and prioritizing work queues to ensure timely and accurate verification of insurance eligibility, benefits, copays, deductibles, out-of-pocket maximums, authorizations, and cost estimates for new and established patients.

• Serves as the primary escalation point for complex insurance verification issues, payer disputes, and patient or provider inquiries related to benefits and financial responsibility.

• Learns and implements AI-powered automation tools and technology solutions that support eligibility verification and cost estimation workflows; trains and supports staff in adoption of new tools.

• Partners with the Revenue Cycle Manager to develop, update, and enforce departmental policies and procedures specific to eligibility and benefits verification; ensures alignment with payer requirements and regulatory standards.

• Maintains current knowledge of payer-specific requirements, regulatory changes (including HIPAA), and industry best practices related to insurance eligibility and benefits coordination.

Minimum Qualifications

• A high school diploma or equivalent required.

• An associate degree in Healthcare Administration, Business Administration, or a related field preferred.

• Five years of healthcare revenue cycle experience, including two years in insurance eligibility, benefits verification, or prior authorization experience and one year of supervisory or team lead experience required.

• Experience with Microsoft Office Suite required.

• Proficiency with payer eligibility portals (Availity, NaviNet, or equivalent) required.

• Experience with an Electronic Health Record (EHR) system required.

• Familiarity with AI-assisted automation tools or Robotic Process Automation (RPA) platforms preferred.

• Knowledge of CPT and ICD-10 coding preferred.

• Continually required to sit, utilize hand and finger dexterity, talk, and hear.

• Work environment is usually quiet to moderate. Frequently working at a desk in front of a computer. Occasionally required to lift and/or move up to 15 pounds.