Hybrid Billing Operations Manager – Eligibility

Posted 15 hours ago

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About the role

  • 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

Benefits

  • Health insurance
  • Flexible work arrangements
  • Professional development

Job title

Billing Operations Manager – Eligibility

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

High School Diploma

Location requirements

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