Senior Manager, Insurance Operations

About TruHearing

TruHearing is a rewarding, fun and friendly, mission-based organization that makes a real difference towards improving people’s lives. Our employees enjoy a positive working environment in a company that has experienced rapid growth. We offer a comprehensive benefits package, educational assistance, and opportunities for advancement.

TruHearing is the market leader and a force for positive change in the hearing healthcare industry. We reconnect people to the richness of life through industry-leading hearing healthcare solutions. We work with insurance companies, hearing aid manufacturers, and healthcare providers to reduce prices and expand access to better hearing care and whole-body health.

TruHearing is part of the WS Audiology Group (WSA), a global leader in the hearing aid industry. Together with our 12,000 colleagues in 130 countries, we invite you to help unlock human potential by bringing back hearing for millions of people around the world. The WSA portfolio of technologies spans the full spectrum of hearing care, from distinct hearing brands and digital platforms to managed care, hearing centers and diagnostics locations.

About The Opportunity

The purpose of this role is to drive results for the insurance team by overseeing daily operations, developing both direct and indirect reports, and leading or supporting key departmental and company initiatives. These initiatives typically focus on scalability, growth, and efficiency in areas such as benefit verification, claims workflows and recovery, and billing activities.

What will you be doing?

Claims & Revenue Cycle Management

• Engage with payer partners’ leadership teams to resolve complex insurance claim issues and develop systems designed to avoid future issues.
• End-to-End Revenue Cycle Management Oversight: Ensure accurate and timely benefit verification, claims submission, adjudication, and payment posting and collection. Partner with Accounting Department to resolve outstanding account receivable issues related to health insurance claims and identify processes to minimize such issues.
• Cash Flow Optimization: Monitor and improve days in accounts receivable, ensuring timely collections and reconciliation.
• OON Claim Lifecycle Management: Oversee end-to-end processing of out-of-network claims, including benefit verification, pricing, submission, and adjudication. Resolve complex OON claim disputes with payers and patients, including appeals and arbitration processes.
• Ensure team is accurately and timely verifying member benefits and processing/adjudicating both in-network and out-of-network claims.
• Work directly with external and internal audit teams, responding to audit requests and ensuring claims adjudication accuracy.
  
  

Technology & Process Management

• Facilitate day-to-day management, and new implementations within the Insurance Operations technology suite (QNTX/Cognizant, Waystar, Trizetto, Availity, Echo, etc.)
• Own, document, and keep current insurance processes, procedures, policies, and training materials.
• Drive innovation and creativity inside of insurance team.
  
  

Team Leadership & Development

• Exemplify true subject matter expertise regarding insurance and identify ways to develop other personnel as additional experts.
• Partner with department leadership to identify objectives and outcomes for the insurance team.
• Drive for results with measurable improvement in employee retention and satisfaction in collaboration with department leaders and HR leadership; build and cultivate a culture of trust, accountability, and engagement within the insurance team.
  
  

Stakeholder & Client Engagement

• Successfully lead/participate in client and vendor-facing activities when requested to present needs and solutions related to insurance functions.
• Build strong relationships inside and outside of the insurance department; respond timely and thoughtfully with all stakeholders to support positive interdepartmental cooperation.
  
  

Forecasting & Performance Management

• Develop forecasting analysis to identify staffing needs and ensure required staffing is in place through partnerships with Workforce Management (WFM), Human Resources (HR), and Finance Departments to ensure interdepartmental cooperation and alignment.
• Create, implement, and measure the effectiveness of initiatives and related incentive plans through tracking metrics and creating custom reports.
  
  

What skills do you need to bring?

In addition to exhibiting the TruHearing Values of Delight, Align, Enjoy, Improve and Be Tru, this role requires the following:

• Managing People – Builds, manages, and motivates teams of people from varied backgrounds and experience levels to accomplish goals and objectives within established policies and procedures.
• Teamwork – Coaches others on how to contribute as a team and removes barriers to exceptional teamwork.
• Productivity – Helps others meet and exceed productivity standards.
• Quality – Reviews and coaches others on quality standards.
• Problem Solving – Connects problem solvers from varying types of expertise to solve complex or timely problems.
• Influence & Persuasion — Crafts persuasive messages and collaborates effectively to make significant impacts on the business.
• Accountability – Holds others accountable to performance, policy, and behavioral standards.
• Initiative – Inspires and empowers others to act.
• Decision Making – Coordinates others to make significant or complex decisions.
• Subject Matter Expertise – Leverages their expertise to expose opportunities and grow expertise in others.
• Planning & Organizing - Coordinates others to carry out plans and objectives.
  
  

What education or experience is required?

Required

• Bachelor’s degree in a related field. A combination of education and experience may be considered in lieu of a formal education.
• Five (5 ) years of experience in a management role.
• Revenue Cycle Expertise: Deep understanding of payer reimbursement methodologies, EOB interpretation, Clearing house systems and procedures, and AR management
• OON Billing Expertise: Deep understanding of OON claim workflows, usual and customary rate calculations, and payer-specific policies
• Regulatory Knowledge: Familiarity with CMS, state insurance regulations, Medicaid, and compliance standards impacting Insurance Operations and RCM.
• Proven experience with driving efficiency and implementing best practices for high performance.
  
  

Preferred

• Master’s degree in a related field.
• Seven (7 ) years of experience managing an insurance and claims operations team.
  
  

What benefits are offered?

TruHearing offers a generous compensation and benefits package including health coverage, a fully vested 401k match, education assistance, fully paid long and short-term disability, paid time off and paid holidays. We are conveniently located across the street from the Draper FrontRunner station and subsidize the cost of a UTA pass with access to FrontRunner, TRAX and regular bus service – employee cost is less than $2 per day. You’ll work in an exciting and fun environment and have the opportunity to grow with us.

Equal Opportunity

TruHearing is an Equal Opportunity Employer who encourages diversity in the workplace. All qualified applicants will receive consideration for employment without regards to race, color, national origin, religion, sex, age, disability, citizenship, marital status, sexual orientation, gender identity, military or protected veteran status, or any other characteristic protected by applicable law.