Senior Manager, Insurance Verification

Manages the insurance verification process to ensure patients are financially cleared for their scheduled service.

• Understands medical and reimbursement policies for all major payers.
• Actively attends executive leadership meetings toward process improvements and revenue growth.
• Interprets and conveys medical policies to the department leadership to assure payer requirements are met for specific high level procedures and surgeries.
• Implements process and procedures with clinical departments to assure proper authorization of high level procedure and surgeries.
• Collaborates with IT to create and implement Epic process design for efficient and timely processing of patient access to services.
• Manages employee productivity through reporting and quality assurance.
• Analyzes reports to assure successful reimbursement of services provided by Baylor Physicians.
• Consistently meets Service Level Agreements with departments for financially clearing a patient.
• Effectively maintains patient clearance rate between 94% to 98%.

• Bachelor’s degree.
• Five years of relevant experience. Degrees in lieu of experience will not be accepted.
• Must have previous Management experience in a medical environment. Infusion Insurance verification management a plus.