Health Insurance Benefits Verification Manager (Remote)

Envision Radiology is adding a Remote Health Insurance Benefits Verification Manager to the team!
Monday - Friday 8:00AM - 5:00PM MST | Position Pay Range $71,250 - $89,050 

Summary/Objective:

The Health Insurance Benefits Verification Manager will lead financial clearance operations including eligibility, benefit coordination, and out-of-pocket estimation. This role plays a critical part in driving patient trust, accurate point-of-service collections, and revenue integrity. The Health Insurance Benefits Verification Manager will bring operational and technical expertise across patient access and the revenue cycle, including system integrations, payer data interpretation, and cross-functional alignment.

Essential Functions

1. Oversees day-to-day operations related to insurance benefit verification, out-of-pocket estimation, and point-of-service collections for all radiology exams (MRI, CT, X-ray, ultrasound, etc.).

2. Maintains rulesets that govern estimation logic, multiple procedure discounts, bundling, and service-specific billing practices.

3. Oversees automation efforts that use eligibility data, payer responses, and HL7/EDI transactions to reduce manual work.

4. Monitors and analyzes estimation accuracy vs. actual claims data to identify trends in payer behavior and patient payment patterns for process improvement.

5. Supports the development and maintenance of insurance carrier rules, financial class logic, and coordination of benefit mappings.

6. Monitors and reports on key performance indicators related to demographic claims rejections, patient collections, bad debt, and refund volumes.

7. Collaborates with Rev Cycle, Scheduling and Billing teams to ensure proper alignment and communication.

8. Other duties as assigned.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Competencies

1. Analytical Thinking.

2. Technical Fluency.

3. Leadership and Accountability.

4. Collaboration.

5. Communication.

6. Process Improvement.

Supervisory Responsibilities

This position provides daily leadership and operational support. This position is also responsible for assisting with performance management and hiring of employees within the Revenue Cycle department.

Work Environment

This job operates remotely and must adhere to the work at home requirements. There may be travel required for Leadership Training, onsite center visit and/or center collaboration.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to use hands and fingers to handle, feel or operate objects, tools or controls, and reach with hands and arms. The employee is frequently required to talk and hear.

Travel

Some travel is expected for this position.

Job Qualifications

Minimum Qualifications/Experience:

• 5+ years of experience in health insurance benefits management or revenue cycle operations, with experience in staff management.

• Strong knowledge of HL7 standards, particularly in the context of eligibility, billing, and registration data.

• Experience with real-time eligibility transactions (270/271).

• In-depth understanding of payer requirements, payer policies, and coordination of benefits.

• Experience with eligibility verification systems, patient estimation tools, and electronic health records.

• Strong analytical and critical thinking skills, with the ability to drive data-informed decisions.

• Ability to manage multiple priorities and implement process improvements across departments.

Education/Certifications:

• Bachelor’s degree in Healthcare Administration, Business, Information Systems, or a related field, or equivalent education, training, and experience.

Additional Eligibility Qualifications

None required for this position.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Compliance

Adheres to Envision’s Code of Conduct and Compliance Policies and attends annual Compliance training as set forth by the Company.

Company Benefits

Below is a list of benefits that are offered to employees, once eligibility is met.

• Health Benefits: Medical/Dental/Vision/Life Insurance

• Company Matched 401k Plan

• Employee Stock Ownership Plan

• Paid Time Off + Paid Holidays

• Employee Assistance Program

OSHA Exposure Rating: 1

It is reasonably anticipated NO employees in this job classification will have occupational exposure to blood and other potentially infectious body fluids.

Envision Radiology is an equal opportunity employer (M/F/D/V). We recruit, employ, train, compensate and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, veteran status, or any other basis protected by application federal, state or local law.

Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.