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:

POSITION SUMMARY:
The Insurance Verification and Authorization (IV/Auth) Manager is responsible for the day-to-day operations and oversight of insurance verification and authorization processes to support uninterrupted patient care and optimal revenue cycle performance. This leader ensures strong team performance and adherence to regulatory guidelines and payer requirements.

Operational Oversight:

• Supervise and support IV/Auth team including hiring, onboarding, scheduling, and performance management
• Monitor daily workflows to ensure SLAs and KPIs (e.g., productivity, accuracy, and turnaround time)
• Implement process improvements to enhance efficiency and reduce denials and write-offs
• Ensure timely resolution of IV/Auth related escalations, edits, and billing holds
• Monitor and ensure departmental budget compliance
• Effective and efficient organization and planning with the proven ability to manage complex multi-workstream performance improvement projects or multiple concurrent client engagements, while delegating and overseeing the work of junior team members

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 address root causes
• Stay current with regulatory and IV/Auth updates and disseminate guidance to staff
• Ensure IV/Auth policies and procedures are current and reflect the most compliant/accepted practices for IV/Auth functions

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 as it relates to communicating payer policy changes
• 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 patients eligibility and authorization status. Obtain clarification as appropriate

Other duties and responsibilities as assigned.

About the Client - Huron
Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

What You Need
Non-negotiables

• IV/Auth Experience: At least 5 years US healthcare revenue cycle experience for insurance verification and authorization functions, 2+ years in healthcare leadership role. Previous experience managing hybrid/remote teams.
• Education: Bachelor's 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 electronic medical records (EMR) such as Epic, Cerner, or Meditech.
• Excellent verbal and written English communication skills and customer service skills (CEFR level of at least B2 for both verbal and written)

Soft Skills

• Proven ability to manage complex multi-workstream performance improvement projects or multiple concurrent client engagements, while delegating and overseeing the work of junior team members
• Ability to pay close attention to details strong follow-up and follow-through skills
• Proven ability to regularly make complex decisions within the scope of the position, and is comfortable working independently
• Proven ability to collaborate with team members and client counterparts to understand business challenges, adapt implementation methodologies and approaches to ensure results align with client's business objectives
• Demonstrated impact through professional written and verbal communication setting clear project team direction, develop key deliverables, escalate risks, and influence key stakeholders inclusive of client and internal senior leadership
• Team leadership experience including building talent, training, supervising, coaching/mentoring, and performance management
• Independent judgment, discretion and decision-making abilities
• Demonstrates teamwork and integrity in all work-related activities
• Ability to interact with internal and external customers in a professional manner
• Strong analytical and critical thinking skills
• Experience in a matrixed environment
• Safeguard patient health information in compliance with HIPAA standards
• Knows, understands, incorporates, and demonstrates Huron's Vision, and Values in behaviors, practices, and decisions.

Preferred Qualifications:

• Software Knowledge: Proficiency with Microsoft office suite (Excel, Word, PowerPoint, Outlook, SharePoint). Proficiency with Data Analytics software (Tableau, PowerBI)
• RCM Knowledge: Prior experience with US healthcare providers or payers

IV Auth (Team) Key Performance Indicators (KPIs) - Expectations (Varies by client scope)

• Team productivity
• Quality Review / Audit standards
• Turnaround time for authorization requests
• Denial and write-off prevention and resolution rates
• Maintenance of AR goals for AR with 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.