Production Manager, Insurance Verifications

Summary

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Primary responsibility is to manage verification production control/inventory and carrier access resolution for all four HMS service centers.? Responsible for building, managing and maintaining the team and supervising all verification department operations.? Will be responsible for employee performance management, work flow management, and adherence to budgetary goals.

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Production Control/Inventory

Manage verification inventory and reporting; ensure all verification target volumes are met; assign inventory workloads to each service center based on needs and abilities; utilize existing reports and electronic tools to identify opportunities to increase production and improve quality; make recommendations o stakeholders to improve efficiencies within the verification process; create new tools/reports to measure various processes and initiatives; and partner with stakeholders to improve the overall service center operations.

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Carrier Access

Identify and resolve carrier access issues impeding the verification process and negatively impacting through-put; partnering with carriers to identify more efficient and/or accurate methods of verification; identify and aggregate carrier access issues across the four service centers for the purpose of being the single point of contact for the particular issue being resolved; communicate with all client management and operations stakeholders regarding carrier access issues.

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Performance will be measured based on:Meeting all verification volume and quality targetsMeasurably increasing verification volumeMeasurably increasing verification qualityReducing the cost per verification by driving new efficiencies

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Requirements

Bachelor's Degree Required, Master's Degree Preferred

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Should have 3 to 5 years health care claims and/or verifications industry experience.? Experience includes supervision of operations staff; working knowledge of insurance/health care terminology and concepts; claims adjudication; eligibility verification; or insurance carrier relations.