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Health Insurance Manager
hace 2 meses
**Job Summary**:
Usa Clinics Group is seeking a highly skilled and experienced Health Insurance Manager to join our team. As a key member of our operations team, you will be responsible for overseeing the productivity and performance of assigned employees, providing reporting and action plans for improvement, and ensuring seamless operations within our healthcare organization.
**Key Responsibilities**:
- Monitor and manage productivity and performance of assigned employees, including daily/weekly/monthly department metrics, to Senior Leadership and provide reporting and action plans for improvement.
- Maintain positive leadership and provide frequent performance feedback to team members, inviting two-way communication.
- Coach established employees when needs are identified, holding employees accountable for results through coaching and development of action plans.
- Monitor Prior Authorization and Eligibility automation processes.
- Assist the IT team in developing new automation processes for authorization submission/tracking and insurance verification.
- Work closely with the billing team for claim denials related to authorization and eligibility.
- Produce productivity and error reports to assess staff.
- Prioritize work to maximize turn-around time.
- Contact insurance plans to determine eligibility, prior authorization, and obtain coverage and benefit information.
- Document findings thoroughly and accurately.
- Perform training with organizational staff on procedures for requesting, documenting, and processing prior authorizations.
**Requirements**:
- High school diploma or equivalent required.
- Bachelor's degree preferred.
- 3 years of BPO experience preferred.
- Strong background and experience in Process improvement LEAN preferred.
- 4+ years in a leadership role preferred.
- Ability to lead a team by demonstrating a positive attitude, openness to change, willingness to help, and respect for others and their ideas.
- Excellent verbal and written communication skills.
- Detail oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment.
- Demonstrated computer literacy and excellent math skills.
- Ability to maintain a high level of confidentiality and professionalism.
- Fluent in English and Spanish required.
**Benefits**:
- IMSS 100%.
- Vacations (after the first year).
- Christmas bonus.
- Weekends off.
- Paid Training.
- Mexican Holidays off.
