Manager, Insurance Operations

Affect Therapeutics

Manager overseeing insurance operations at Affect's virtual mental health treatment program. Responsible for managing insurance verification and workflows to facilitate claims processes.

Posted 4/24/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSeniorWebsite

Tech Stack

Tools & technologies

Swift

About the role

Key responsibilities & impact

Own the entire "pre-claim" insurance lifecycle: from the moment a potential member’s insurance is triggered for verification to the point their claim is successfully billed.
Design and manage a seamless VOB workflow to ensure swift and accurate payer coverage before a member’s first session.
Own the process to identify members whose insurance has lapsed and manage the outreach process to secure new coverage or payment plans.
Own the resolution of Coordination of Benefits (COB) issues, working directly with members and payers to ensure the correct primary/secondary order is established.
Own and optimize workflows to request, track, and renew prior authorizations, leveraging existing tools and identifying opportunities for automation and improvement.
Analyze rejection patterns within Candid to identify root causes related to authorizations or member data and implement upstream fixes.
Partner closely with the RCM team, who owns claim submission and collections, while your team owns the accuracy and completeness of all upstream insurance data.
Serve as a primary operational point of contact for insurance payers, resolving eligibility, authorization, and member data issues and escalating systemic challenges as needed.
Oversee the member-facing side of the billing process (e.g., invoices, collections of copays/deductibles) to ensure it aligns with Affect’s compassionate mission.
Manage external vendors involved in eligibility checking, specialized insurance discovery, and active member insurance issues.
Provide regular reporting on key KPIs, such as time-to-verify insurance for potential members, percentage of COB denials, and more.

Requirements

What you’ll need

3-5+ years of experience in healthcare operations, insurance operations, or revenue cycle, with direct experience in eligibility, benefits verification, and prior authorizations
Strong understanding of:
Insurance eligibility and benefits (commercial + Medicaid preferred)
Prior authorization workflows and payer requirements
COB resolution
Experience partnering with RCM and/or billing teams to reduce denials and improve clean claim rates
Experience working with external vendors and managing performance against SLAs
Proven ability to manage and improve operational workflows with strong attention to detail
Ability to demonstrate a commitment to quality and excellence
Exceptional analytical and problem-solving skills
Systems thinker
Committed to a high ethical standard in everything you do
Familiarity with EMRs, Practice Management solutions, Metabase (or other BI tools), Google Suite, and Slack.

Benefits

Comp & perks

Health insurance
Flexible work arrangements
Professional development

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

insurance eligibilitybenefits verificationprior authorizationsCoordination of Benefits (COB)operational workflowsanalytical skillsproblem-solving skills

Soft Skills

attention to detailcommitment to qualitysystems thinkinghigh ethical standard