Insurance Verification and Authorization (IV/Auth) Manager

Discover your 100% YOU with MicroSourcing!

Position: Insurance Verification and Authorization (IV/Auth) Manager
Location: Taguig
Work setup & shift: Onsite | Night shift

Why join MicroSourcing

Youu0027ll have:

• Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
• A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
• Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
• Career Growth: Take advantage of opportunities for continuous learning and career advancement.
• Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Your Role
As an IV/Auth Manager, you will:
Operational Oversight

• Supervise and support the IV/Auth team including hiring, onboarding, scheduling, and performance management.
• Monitor daily workflows to ensure SLAs and KPIs (productivity, accuracy, turnaround time) are met.
• Implement process improvements to enhance efficiency and reduce denials and write-offs.
• Ensure timely resolution of IV/Auth escalations, edits, and billing holds.
• Monitor departmental budget compliance and oversee complex multi-workstream performance improvement projects.

Quality & Compliance

• Monitor IV/Auth audits and accuracy reviews, ensuring compliance with payer requirements and regulatory guidelines.
• Address IV/Auth related denials and partner with billing and A/R teams to identify and resolve root causes.
• Stay current with regulatory and IV/Auth updates and disseminate guidance to staff.
• Ensure IV/Auth policies and procedures reflect the most compliant and accepted practices.

Collaboration & Support

• Work closely with clients and other departments to ensure clean claim generation.
• Maintain escalation protocols for urgent cases and payer disputes.
• Coordinate with IT on system optimization.
• Provide regular performance reports and participate in client meetings.

Education & Training

• Provide regular IV/Auth education for team development, especially on payer policy updates.
• Mentor IV/Auth supervisors or specialists to support succession planning and career development.

Coordinating with Healthcare Providers

• Work closely with physicians, nurses, and other healthcare professionals to ensure timely and accurate documentation that reflects patientsu0027 eligibility and authorization status.
• Perform other duties and responsibilities as assigned.

What You Need
Non-negotiables

• IV/Auth Experience: At least 5 years in US healthcare revenue cycle experience for insurance verification and authorization, with 2+ years in a healthcare leadership role.
• Education: Bacheloru0027s degree or equivalent in Business, Health Information Management, Healthcare Administration, or related field.
• RCM Knowledge: Strong knowledge of insurance verification, prior authorization, CPT/ICD-10 codes, and payer guidelines.
• Software Knowledge: Proficiency with payer portals, eligibility and authorization tools (e.g., Availity), and hospital EMRs such as Epic, Cerner, or Meditech.
• Excellent verbal and written English communication skills (CEFR B2 minimum) and customer service skills.
• Leadership experience managing hybrid/remote teams.

Preferred skills/expertise

• Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Outlook, SharePoint) and data analytics software (Tableau, PowerBI).
• Prior experience with US healthcare providers or payers.
• Proven ability to manage complex multi-workstream projects while delegating and overseeing junior team members.
• Strong attention to detail with excellent follow-up and follow-through skills.
• Demonstrated teamwork, integrity, and professional judgment.
• Strong analytical and critical thinking skills experience in a matrixed environment.
• Ability to safeguard patient health information in compliance with HIPAA standards.
• Aligns with Huronu0027s vision, values, and professional standards in all decisions and practices.

Key Performance Indicators (KPIs)

• Team productivity and efficiency.
• Quality review/audit standards.
• Turnaround time for authorization requests.
• Denial and write-off prevention and resolution rates.
• Maintenance of AR goals for IV/Auth related billing holds/edits.
• Adherence to SLAs.
• Client satisfaction.

About MicroSourcing
With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU
MicroSourcing firmly believes that our companyu0027s strength lies in our peopleu0027s diversity and talent. We foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds.

At MicroSourcing, equality is not merely a slogan - itu0027s our commitment. Our way of life. Here, we donu0027t just accept your unique authentic self - we celebrate it, valuing every individualu0027s contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit https://www.microsourcing.com/
Terms & conditions apply.