Insurance Verification Operations Lead
Recora Inc.
contract
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $35 per hour
Job Level
About the role
- Own the day-to-day execution of insurance verification operations, ensuring verifications are completed within required SLAs and prioritized appropriately based on payor behavior, plan complexity, and business urgency.
- Provide functional oversight and guidance to the insurance verification team, ensuring consistent performance, clear prioritization, and adherence to best practices.
- Serve as a subject-matter expert for insurance denials, partnering with external partners to investigate, resolve, and prevent denials related to eligibility, benefits, and authorization errors.
- Perform ongoing quality assurance on verification calls and records, identifying trends, gaps, and training opportunities to continuously improve outcomes.
- Handle complex patient escalations related to insurance coverage, benefits, cost-sharing, and authorization requirements, including direct patient outreach when needed.
- Translate payor-specific nuances, denial patterns, and verification learnings into clear operational guidance for the team.
- Partner closely with cross-functional stakeholders (operations, partnerships, product) to ensure verification processes scale effectively as volume and complexity increase.
Requirements
- 10+ years of experience in insurance verification, prior authorization, and/or revenue cycle management, with deep familiarity across Medicare and Medicare Advantage payors.
- Demonstrated experience overseeing insurance verification functions or teams, including performance monitoring, QA, and process improvement.
- Exceptional technical proficiency, including advanced Excel skills; candidates should expect to complete an Excel-based assessment.
- Deep understanding of payor behavior, denial drivers, and verification best practices, with the ability to apply that knowledge in real-time operational decision-making.
- Comfort working in a startup environment where processes are evolving and ownership is critical.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
insurance verificationprior authorizationrevenue cycle managementquality assuranceprocess improvementExcel
Soft skills
functional oversightteam guidanceperformance monitoringproblem-solvingcommunication