Insurance Verification Manager

Responsibilities

• Oversight of daily insurance verification activities to ensure accuracy and timely completion of eligibility, benefits, and plan details.
• Establish and enforce standardized verification workflows, documentation requirements, and quality controls.
• Ensure verification processes support accurate treatment estimates, fee presentation, and downstream billing.
• Partner with billing, accounts receivable (AR), and operations teams to resolve verification-related issues and prevent denials or rework.
• Lead the implementation of automated insurance verification solutions, including vendor-provided platforms and internal system capabilities.
• Serve as the business owner for automation initiatives, defining requirements, success metrics, and operational workflows.
• Partner with IT, vendors, and operational stakeholders to support system configuration, testing, rollout, and post-implementation optimization.
• Ensure automation tools integrate effectively with practice management systems and existing workflows.
• Maintain monitoring of automation performance, accuracy, and exception rates; adjust processes to maximize efficiency and quality.
• Lead change management efforts, including training, communication, and adoption support for office and centralized teams.
• Act as the primary point of contact for third-party insurance verification vendors and automation partners.
• Manage vendor performance against service level agreements (SLAs), turnaround times, accuracy standards, and automation effectiveness.
• Conduct regular vendor performance reviews, including quality audits, reporting analysis, and issue resolution.
• Collaborate with vendors to ensure alignment with internal systems and automation strategies.
• Escalate and resolve vendor-related issues impacting office operations, automation performance, or financial outcomes.
• Set performance expectations, monitor productivity and quality metrics, and address gaps through coaching or process improvement.
• Foster a culture of accountability, continuous improvement, and technology adoption.
• Monitor key performance indicators (KPIs) such as verification timeliness, accuracy, denial prevention, vendor performance, and automation effectiveness.
• Analyze trends to identify opportunities for increased automation, workflow optimization, or vendor enhancements.
• Partner with analytics and revenue cycle management (RCM) leadership to develop dashboards and reporting supporting operational and strategic decisions.
• Lead initiatives to reduce manual effort, improve scalability, and enhance the patient and office experience through automation.
• Ensure verification workflows and automated solutions comply with payer requirements, internal policies, and regulatory standards.
• Partner cross-functionally with IT, operations, finance, and clinical leadership to align automation initiatives with enterprise goals.
• Support system upgrades, vendor transitions, and process changes related to insurance verification and automation.

Qualifications

• Bachelor’s degree or equivalent experience in healthcare, business, or revenue cycle management.
• 5+ years of experience in insurance verification, eligibility, or revenue cycle operations.
• 2+ years of people management experience.
• Demonstrated experience managing third-party vendors and/or automated insurance verification solutions.
• Strong understanding of dental insurance plans, eligibility rules, and benefit structures.
• Proven ability to lead change, implement new tools, and drive adoption across teams.