· Lead and supervise the Verification Authorization team, ensuring accurate and timely insurance verification, prior authorizations, and benefit assessments.
· Develop and monitor team performance metrics, ensuring goals are met for turnaround time, accuracy, and payer compliance.
· Collaborate with payers to resolve eligibility discrepancies, denials, and escalations.
· Work closely with Revenue Cycle leadership to identify trends, gaps, and opportunities for process improvements.
· Implement and update policies and procedures to ensure compliance with regulatory and payer requirements.
· Train, coach, and mentor team members to enhance knowledge of payer guidelines, systems, and best practices.
· Partner with cross-functional teams Billing to support a seamless patient and provider experience.
· Provide regular reporting and analysis of eligibility performance, including KPIs, denial trends, and payer turnaround times.
· Manage staffing schedules, workload distribution, and productivity standards to ensure operational coverage and efficiency.
· Support system implementations, testing, and enhancements related to eligibility processes.
· Provide strategic direction, coaching, and professional development to foster a high-performance culture.
· Lead by example and promote a culture of accountability and continuous improvement.
· Identify and implement process enhancements to improve efficiency, reduce error rates, and support scalability.
· Standardize procedures and documentation across the department.
· Evaluate and implement technology solutions and reporting tools to support automation and performance tracking.
· Ensure adherence to HIPAA, payer rules, and all relevant state and federal regulations.
· Stay current on industry best practices, regulatory updates, and payer changes impacting billing and date of service requirements.