Manager, Eligibility and Benefits

🕒 5 days ago

🏄 California – Remote

🏄 California – Remote

💵 $87.4k - $104k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Boomerang Healthcare

WebsiteLinkedInAll Job Openings

201 - 500 employees

💼 Consulting

⚖️ Legal

🏥 Healthcare

Consulting • Legal • Healthcare

Boomerang Healthcare is an early-stage or placeholder website for a company that appears to operate in the healthcare sector. The site currently shows a "coming soon" message and provides no public information about services, products, or target customers, so specific activities (e. g. , insurance, staffing, software) cannot be determined from the available content. The business is likely developing or preparing to launch its online presence.

📋 Description

• Direct the daily operations of the insurance verification, financial clearance, and point-of-service collection teams across all clinical specialties • Standardize electronic eligibility workflows • Ensure accurate coverage data entry • Eliminate front-end office claim denials • Implement strict processes to accurately calculate and successfully collect patient co-pays, deductibles, and outstanding prior balances before or on the date of service • Supervise, train, and schedule eligibility verification and insurance specialist teams • Ensure estimated patient financial responsibility is identified prior to service whenever information is available • Support accurate communication of expected copays, deductibles, coinsurance, and other patient responsibility • Establish escalation procedures for high-dollar patient responsibility, coverage exclusions, or benefit limitations requiring additional patient communication • Oversee eligibility verification workflows for diverse clinical lines, ranging from specialty care to high-cost surgical and diagnostic specialties • Partner with billing and coding teams to analyze backend rejection data and implement root-cause fixes for eligibility-related claim denials • Serve as the primary administrator for major commercial payer portals, including Availity, Optum, United Healthcare, and Anthem • Assume other responsibilities as appropriate to the position and organizational needs

🎯 Requirements

• Minimum 5 years of experience in healthcare revenue cycle, patient access, eligibility, benefits, or related experience • Experience working with Medicare and commercial insurance plans • Strong understanding of deductibles, copays, coinsurance, out-of-pocket maximums, referrals, prior authorization requirement, coordination of benefits • Proven track record of managing and improving front-end or point-of-service collection rates in a healthcare setting • At least 2-3 years of direct supervisory or management experience leading healthcare administrative teams • Expert-level understanding of commercial insurance products, including HMO, PPO, and EPO • Advanced, hands-on experience utilizing enterprise-level EHR platforms (e.g. Epic, IMS, e-Clinical Works) and integrated payment collection software • Advanced proficiency in Microsoft Excel (e.g., formulas, pivot tables) • Solid skills in other Microsoft Office applications • Monday-Friday, 8am-5pm • 40

🏖️ Benefits

• Amazing work/life balance • Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO) • 401(K) Plan with Employer Matching • License & Tuition Reimbursements • Paid Time Off • Holiday Pay & Floating Holiday • Employee Perks and Discount Programs • Supportive environment to help you grow and succeed