Manager, Benefit Verification & Authorization Operations Salary Range: $80k-$90k The Role The Manager, Benefit Verification & Authorization Operations is responsible for leading Prompt’s Benefit Verification and Authorization teams, ensuring accurate, timely, and consistent execution across our RCM clients. This role directly manages the Benefit Verification and Authorization Team Leads and is accountable for overall team performance, quality, service levels, and operational efficiency. The Manager will use data to identify performance gaps, resolve escalations, develop team leaders, and continuously improve processes that support patient access and prevent downstream billing and reimbursement issues. Key Responsibilities Team Leadership & Operations Lead the Benefit Verification and Authorization functions, ensuring teams consistently meet quality, productivity, and turnaround-time expectations. Directly manage and develop the Benefit Verification and Authorization Team Leads. Ensure workloads, staffing, and priorities are aligned with client volumes and business needs. Establish clear expectations and accountability across both teams. Support Team Leads with complex operational, payer, client, and employee escalations. Build a high-performing culture centered on accuracy, urgency, accountability, and ownership. Performance & Quality Own key performance metrics and SLAs across Benefit Verification and Authorization. Monitor verification accuracy, turnaround times, authorization approval rates, pending authorizations, backlog, productivity, and authorization-related denials. Use reporting and dashboards to identify performance gaps, payer trends, and operational risks. Partner with Team Leads to implement corrective action plans when performance falls below expectations. Ensure consistent quality assurance and auditing processes are in place across both teams. Operational Oversight & Escalations Ensure patients have accurate benefit information and required authorizations are identified and managed appropriately. Ensure teams proactively identify missing, pending, expiring, or exhausted authorizations before they impact scheduled visits or reimbursement. Serve as the management-level escalation point for complex payer, client, and workflow issues. Analyze recurring verification and authorization issues to identify root causes and prevent future occurrences. Partner with Billing, AR, and other RCM teams to reduce downstream denials and reimbursement delays. Process Improvement Identify opportunities to improve Benefit Verification and Authorization workflows, accuracy, and scalability. Standardize processes and best practices across teams and clients. Identify opportunities for automation and system improvements that reduce manual work. Partner with …
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