Billing Operations Manager overseeing the Eligibility function within Billing Operations team at Caris Life Sciences. Responsible for insurance verification, leadership, and process improvements.
Responsibilities
Lead and manage the Eligibility team, ensuring accurate and timely insurance verification, prior authorizations, and benefit assessments
Develop and monitor team performance metrics, ensuring goals are met for turnaround time, accuracy, and payer compliance
Collaborate with payers to resolve eligibility discrepancies, denials, and escalations
Work closely with Revenue Cycle leadership to identify trends, gaps, and opportunities for process improvements
Implement and update policies and procedures to ensure compliance with regulatory and payer requirements
Train, coach, and mentor team members to enhance knowledge of payer guidelines, systems, and best practices
Partner with cross-functional teams Billing to support a seamless patient and provider experience
Provide regular reporting and analysis of eligibility performance, including KPIs, denial trends, and payer turnaround times
Manage staffing schedules, workload distribution, and productivity standards to ensure operational coverage and efficiency
Support system implementations, testing, and enhancements related to eligibility processes
Provide strategic direction, coaching, and professional development to foster a high-performance culture
Lead by example and promote a culture of accountability and continuous improvement
Identify and implement process enhancements to improve efficiency, reduce error rates, and support scalability
Standardize procedures and documentation across the department
Evaluate and implement technology solutions and reporting tools to support automation and performance tracking
Ensure adherence to HIPAA, payer rules, and all relevant state and federal regulations
Stay current on industry best practices, regulatory updates, and payer changes impacting billing and date of service requirements
Requirements
High School diploma or equivalent required
5–7 years of experience in healthcare billing operations, with at least 2–3 years in a supervisory or management role
Strong knowledge of CPT, ICD-10, HCPCS coding, payer regulations, and revenue cycle management
Ability to lead cross-functional initiatives and manage timelines, resources, and deliverables
Experience with Medicare Advantage plans and familiarity with Xifin is a plus
Demonstrated ability to lead teams, manage change, and drive performance in a fast-paced environment
Proficiency in Microsoft Office Suite (Excel, Word, Outlook, Access) and healthcare billing systems
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