Description

About Our Company

Advanced Diabetes Supply® was founded on the bold principle of creating a knowledgeable, reliable and demonstrably superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has catapulted Advanced Diabetes Supply® to a national leader in the industry. Creating high-performance, adaptive teams requires a relentless commitment to hiring the best. We strive to maintain a casual, fun environment whenever possible, but we don’t just play around. We work hard every day to provide a positive work culture and respectful atmosphere. The standards we set for ourselves are high, and we love to be challenged! If you enjoy working in a collaborative environment, have a passion for excellence and a bias for action, we may be just what you’ve been looking for.

Interested in learning more about our company and its culture? Visit us at www.northcoastmed.com

About The Position

The Insurance Verification Manager oversees the insurance verification process within the organization, ensuring accuracy, efficiency, and compliance with industry standards and regulations. They manage a team responsible for verifying patient insurance coverage, obtaining authorizations for services, and resolving insurance-related issues.

Essential Functions 

• Supervises and leads a team of insurance verification specialists.
• Provides training, guidance, and performance evaluations to team members.
• Fosters a positive and collaborative work environment to maximize team productivity and morale.
• Develops and implement standardized procedures for insurance verification.
• Oversees the verification of patient insurance coverage for medical services.
• Ensures timely verification of insurance benefits and eligibility.
• Coordinates the authorization process for medical procedures and services requiring pre-authorization.
• Communicates with insurance companies to obtain necessary authorizations and resolve authorization-related issues.
• Monitors authorization status to ensure compliance with payer requirements and minimize denials.
• Collaborates with billing and coding teams to resolve insurance-related claim rejections and denials.
• Investigates and address discrepancies in insurance coverage and billing information.
• Implements strategies to minimize claim denials and optimize reimbursement.
• Stays updated on changes in insurance regulations, policies, and procedures.
• Ensures compliance with HIPAA regulations and other relevant healthcare laws.
• Conducts regular audits to assess the accuracy and completeness of insurance verification processes.
• Establishes key performance indicators (KPIs) for insurance verification processes.
• Monitors performance metrics and analyze trends to identify areas for improvement.
• Generates reports and provide insights to management regarding insurance verification efficiency and effectiveness.
• Embraces and exemplifies ADS core values:

*We put our people first. 

*We serve our members with passion.

*We take ownership.

*We pursue excellence.

*We never stop growing.

• May perform any additional responsibilities or special projects as required.
• May provide cross-functional support as business needs demand.
• Duties and responsibilities may be subject to change based upon the needs of the department.

Requirements

• Bachelor’s degree in healthcare administration, business administration, or related field.
• Previous experience in healthcare insurance verification, with at least 4 years in a managerial or supervisory role.
• Expertise in insurance verification software and electronic health record (EHR) systems.
• Knowledge of medical insurance terminology, billing practices, and reimbursement processes.
• Familiarity with regulatory requirements, such as HIPAA, and industry best practices in insurance verification.

 Expected Competencies  

• Friendly, professional, and effective communications skills; able to calmly present solutions in challenging situations.
• Proactive identification of challenges, and solution-oriented approach to problem solving.
• Service-orientation and aptitude to utilize proper listening skills.
• Effective analytical skills: able to use inductive and deductive reasoning to anticipate outcomes.
• Self-directed accountability and reliability
• Effective leadership, communication, and interpersonal skills, with the ability to influence and collaborate effectively with cross-functional teams.
• Able to manage and prioritize multiple tasks/projects, work autonomously, and meet deadlines.
• Able to work well in a team environment that promotes inclusiveness and communication among team members.
• Communication using both verbal and written English proficiency.
• Cultural competence

 Physical Demands 

The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable employees with disabilities to perform the essential functions.

While performing the responsibilities of the job, the employee is required to remain in a stationary position most of the time (stand or sit). While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is frequently required to stand, walk, and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

 Other Requirements 

• Candidates must successfully pass a background check.
• Candidates must be able to provide proof of eligibility to work in the United States without sponsorship.

Pay Range and Compensation Package 

Pay ranges may vary depending on location. The general pay range for this position is $74,000 - $78,000. Actual compensation depends on education, experience, and relevant skills. In addition, benefits include:

• Health, Dental & Vision options
• FSA and HSA plan with Employer Contribution
• Employer paid EAP
• 401k with 4% Company Match
• Discretionary Profit-Sharing Plan
• Paid Time Off (PTO) Including 7 Paid Holidays and a Birthday Holiday
• On-Site Gym
• In-house Training Programs
• A fun culture in a fast-growing organization!

Equal Opportunity Statement 

Advanced Diabetes Supply® provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.