Billing Operations Manager – Eligibility
Caris Life Sciences
full-time
Posted on:
Location Type: Hybrid
Location: Irving • Texas • United States
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About the role
- Lead and manage the Eligibility 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
Requirements
- High School diploma or equivalent required
- 5–7 years of experience in healthcare billing operations, with at least 2–3 years in a supervisory or management role
- Strong knowledge of CPT, ICD-10, HCPCS coding, payer regulations, and revenue cycle management
- Ability to lead cross-functional initiatives and manage timelines, resources, and deliverables
- Experience with Medicare Advantage plans and familiarity with Xifin is a plus
- Demonstrated ability to lead teams, manage change, and drive performance in a fast-paced environment
- Proficiency in Microsoft Office Suite (Excel, Word, Outlook, Access) and healthcare billing systems
Benefits
- Health insurance
- Flexible work arrangements
- Professional development
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
CPT codingICD-10 codingHCPCS codingrevenue cycle managementinsurance verificationprior authorizationsbenefit assessmentsperformance metricsprocess improvementsautomation
Soft Skills
leadershipcoachingmentoringcollaborationstrategic directionaccountabilitycontinuous improvementchange managementteam managementcommunication