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Manager, Eligibility and Benefits

🕒 August 27

🏄 California – Remote

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đŸ’” $87.4k - $104k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

đŸ‘» Ghost score 15%

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Logo of Boomerang Healthcare

Boomerang Healthcare

201 - 500 employees

đŸ’Œ Consulting

⚖ Legal

đŸ„ 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 and eliminate front-end office claim denials ‱ Implement processes to ensure patient co-pays, deductibles, and outstanding prior balances are accurately calculated and collected prior to 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 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, and 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

đŸ–ïž 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

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