The Manager of Eligibility & Benefits directs the daily operations of the insurance verification, financial clearance, and point-of-service collection teams across all clinical specialties. This role is responsible for standardizing electronic eligibility workflows, ensuring accurate coverage of data entry, and eliminating front-end office claim denials. Additionally, the manager drives revenue retention by implementing strict processes that ensure patient co-pays, deductibles, and outstanding prior balances are accurately calculated and successfully collected prior to or on the date of service.
*This is a remote role
What you will do:
- 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
- Multi-Specialty Workflow Management: Oversee eligibility verification workflows for diverse clinical lines, ranging from specialty care to high-cost surgical and diagnostic specialties
- Denial Prevention: Partner with the billing and coding teams to analyze backend rejection data and implement root-cause fixes for eligibility-related claim denials
- Payer Portal Governance: Serve as the primary administrator for major commercial payer portals (E.g., Availity, Optum, United Healthcare, Anthem) to resolve complex coverage issues
- Assumes other responsibilities as appropriate to the position and organizational needs
Qualifications:
- 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
- Process Improvement Expertise: Proven track record of managing and improving front-end or point-of-service collection rates in a healthcare setting
- Leadership: At least 2-3 years of direct supervisory or management experience leading healthcare administrative teams
- Payer Knowledge: Expert-level understanding of commercial insurance products, including HMO, PPO, and EPO.
- System Proficiency: 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) and solid skills in other Microsoft Office applications
Compensation Range:
$87,360 - $104,000 annually
All compensation ranges are posted based on internal equity, job requirements, experience, and geographical locations.
Why You'll Love Working Here:
- 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
Boomerang Healthcare (BHC) is a multidisciplinary and comprehensive team of experienced, committed healthcare providers that treat pain. Our team of doctors approaches each patient with one goal in mind: to help patients return to normal daily activities. We work with our patients to identify the cause of their pain and create a personalized treatment plan, recognizing that no two patients are alike, and neither is their pain. Our providers create a comprehensive care plan, then monitor, manage and coordinate patient access to health services at BHC.
Boomerang Healthcare strives to be a diverse workforce that reflects, at all job levels, the patients we serve. We are an equal opportunity employer. Boomerang Healthcare is committed to compliance with the American Disabilities Act. If you require reasonable accommodation during the application process or have a question regarding an essential job function, please contact us.
Monday-Friday, 8am-5pm
40
Skills Required
- At least 5 years of experience in healthcare revenue cycle, patient access, eligibility, benefits, or related work
- Experience working with Medicare and commercial insurance plans
- Strong understanding of deductibles, copays, coinsurance, out-of-pocket maximums, referrals, prior authorization requirements, and coordination of benefits
- Proven experience 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 plans
- Advanced hands-on experience with enterprise-level EHR platforms such as Epic, IMS, or eClinicalWorks
- Experience with integrated payment collection software
- Advanced proficiency in Microsoft Excel, including formulas and pivot tables
- Solid proficiency in other Microsoft Office applications
What We Do
We are dedicated to restoring your hope and helping you return to better health with our unique individual treatment plans. Our expanding network of Providers & Specialists are dedicated to helping you achieve your goals. Our services range from cutting edge interventional pain management and psychological support to physical therapy and functional restoration. Our providers are also subspecialty-trained in the diagnosis and treatment of spinal diseases and interventional procedures including implantable technology. Aside from providing a community-based practice, IPM Medical Group, Inc. has taken further steps to become one of the premier referral centers for the injured worker. With additional services such as disability management and medical-legal evaluations, IPM Medical Group, Inc. is proud to have become the standard of quality care for both injured workers and community patients. Thank you for considering our practice for your pain management needs.
