Remote Benefit Verification Manager en The Emily Program

Position Summary: The Benefit Verification Manager is responsible for the day-to-day management of the Client Access Representative (CAR) team.  The position has direct accountability for the CAR team’s key performance indicators (KPI’s): benefit verification timeliness and accuracy (new client benefit verifications completed at least one business day before the client’s assessment) and maintaining fewer than 10 open billing tickets at any given time.  The position is responsible for ensuring staff obtain all outpatient authorizations to ensure payment for rendered services.    

Duties and Responsibilities:  

• Day to day leadership of CAR team and first point of contact for any CAR team related escalations. 

• Weekly quality monitoring and feedback loop (reviewing a minimum of 5 benefit verifications for each team member and clarification/retraining as appropriate)    

• Ensure timely, accurate, comprehensive benefit verifications are completed the business day prior to a client’s scheduled assessment. 

• Ensure the CAR team correctly enters insurance information into a client’s chart for proper billing of services and timely reimbursement. 

• Monitor outpatient authorizations to ensure the CAR team is obtaining authorizations for all required services.  

• Weekly monitoring of open tickets to ensure the team has fewer than 10 open tickets assigned to them at any given time and response timelines on tickets fall within the team expectations. 

• Proactively identify, address and escalate (as needed) issues impacting clients’ access to care. 

• Generate a monthly worklist of all clients in higher levels of care (Intensive Outpatient, Partial Hospitalization, Residential, and Inpatient) and ensure team reviews all account to confirm each client’s insurance coverage is still active.   

• Semi-monthly live call audits of each CAR team member. 

• Weekly 1:1 with each CAR team member including performance management and completion of annual performance reviews. 

• Provide weekly KPI updates to the Director of Utilization Review  

• Daily review of the Benefit Verification Report including updating the Benefit Verification quarterly trends file.  Monitor team performance and make caseload adjustments as needed based off staffing levels, demand, etc.  

• Monitor the team shared Outlook mailbox for timely and accurate responses. 

• Lead regular team meetings and maintain detailed meeting minutes to be shared with the team following each meeting. 

• Manage timecards and PTO for all direct reports; ensuring adequate coverage when approving PTO. 

• Recruitment of new staff, as needed, including developing the onboarding plan and supporting training new hires. 

• Fostering positive and collaborate partnerships with all internal and external stakeholders. 

• Participates in regular 1:1 with Director of Utilization Review  

• Supports the Director of Utilization Review to create and update policies, guidelines and workflows. 

• Other duties as assigned.  

Education Qualifications: 

• Bachelor’s degree (required)  

Professional Qualifications: 

• 3+ years of insurance authorization and/or benefit verification experience (required) 

• 2+ years of healthcare management experience (required)  

• Basic knowledge of MS Office Suite with ability to learn new applications. 

Competencies: 

• Strong attention to detail and commitment to quality. 

• Ability to communicate effectively with clear and concise communication. 

• Solid interpersonal skills with demonstrated ability to develop and maintain productive relationships. 

• Demonstrate initiative and exercise good judgment (e.g., in starting tasks, asking questions, identifying and discussing problems, ability to structure own work, stay on task). 

• Ability to prioritize and adapt to changing priorities. 

• Shows passion for our business, clients, and values. 

Workplace Environment:  

• Ability to adjust to a workflow pace that fluctuates widely.  

• Remote position, private workspace required 

Accanto’s Commitment to Equal Opportunity: Accanto is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national origin, gender, sexual orientation, gender identity, age, physical or mental disability, genetic factors, military/veteran status, or other characteristics protected by law.