Insurance Manager

hace 1 semana

Tijuana, México USA Clinics Group A tiempo completo

**Job Description**:

- Clinical documentation improvement specialists
- Administrative staff and clerks

**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.
- Maintains positive leadership and gives frequent performance feedback to team members and invites two-way communication.
- Coaches 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 IT team in developing new automation processes for authorization submission/tracking and insurance verification
- Work closely with billing team for claim denials related to authorization and eligibility
- Produces productivity and error reports to assess staff.
- Prioritize work to maximize turn-around time.
- Contacts insurance plans to determine eligibility and obtain coverage and benefit information.
- Contacts insurance plans to obtain prior authorization for services.
- Documents findings thoroughly and accurately.
- Performs 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

**Benefits**
- IMSS 100%
- Vacations (after the first year)
- Christmas bonus
- Paid Training
- Weekends off
- Mexican Holidays off

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