Manager, Benefit Verification & Authorization Operations

Job not on LinkedIn

🔥 0 minutes ago

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Prompt Therapy Solutions Inc

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Prompt Therapy Solutions Inc. is a company that provides therapy-focused software solutions designed to enhance the efficiency and profitability of clinics. They offer a range of features including AI-powered scheduling, patient management, billing, and reporting tools. Their platform caters to various practice sizes, from startup clinics to large enterprises, aiming to optimize clinic operations and improve patient satisfaction. The company's AI solutions help streamline workflows for roles such as front desk staff, therapists, billers, and clinic owners. Through advanced analytics and automated processes, Prompt Therapy Solutions seeks to modernize practice management and drive growth for therapy providers.

📋 Description

• Lead Prompt’s Benefit Verification and Authorization functions across RCM clients • Directly manage and develop Benefit Verification and Authorization Team Leads • Align workloads, staffing, and priorities with client volumes and business needs • Establish expectations and accountability across both teams • Support complex operational, payer, client, and employee escalations • Own performance metrics and SLAs, including accuracy, turnaround times, approval rates, pending authorizations, backlog, productivity, and denials • Use reporting and dashboards to identify performance gaps, payer trends, and operational risks • Implement corrective action plans and quality assurance/auditing processes • Ensure accurate benefit information and appropriate identification and management of required authorizations • Identify missing, pending, expiring, or exhausted authorizations before they affect visits or reimbursement • Serve as the management-level escalation point for complex payer, client, and workflow issues • Analyze recurring issues, identify root causes, and prevent future occurrences • Partner with Billing, AR, and other RCM teams to reduce denials and reimbursement delays • Improve and standardize Benefit Verification and Authorization workflows across teams and clients • Identify automation and system improvements to reduce manual work • Partner with RCM leadership, Product, and BI on reporting, workflow, and system enhancements • Communicate, implement, and monitor process and system changes • Ensure onboarding, training, coaching, SOPs, payer resources, and workflow documentation are maintained

🎯 Requirements

• 5+ years of experience in healthcare revenue cycle management, patient access, Benefit Verification, Prior Authorization, or related healthcare operations • 2+ years of people management experience, preferably within healthcare operations • Strong knowledge of insurance eligibility, benefits, prior authorization, and payer requirements • Experience managing teams against productivity, quality, and turnaround-time expectations • Strong analytical and problem-solving skills, including root-cause analysis and solution implementation • Demonstrated ability to manage complex operational and payer escalations • Strong leadership, coaching, and performance management skills • Experience improving and standardizing operational processes • Experience with practice management systems, payer portals, healthcare technology platforms, and reporting tools • Ability to work independently and manage competing priorities in a fast-paced environment • Compliance with HIPAA regulations and patient health information protection requirements • Must be legally authorized to work in the US and physically located in the US