Insurance Verification Operations Lead

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  • Company Recora, Inc
  • Employment Full-time
  • Location 🇺🇸 United States nationwide
  • Submitted Posted 1 day ago - Updated 4 hours ago
<p><strong>Job Title:</strong> Insurance Verification Operations Lead (1099)</p><p><strong>Classification: </strong>Full Time/1099 Contractor</p><p><strong>Work Structure:</strong> Fully Remote</p><p><strong>Schedule/Shift:</strong> Monday-Friday; 7:30am-8:30am ET OR 8a-4p ET</p><p><strong>Team:</strong> Clinical Operations</p><p><strong>Location:</strong> United States</p><p><strong>Compensation:</strong> $35 per hour</p><p><br><br></p><p><strong>Overview</strong></p><p>We are seeking a highly experienced <strong>Insurance Verification Operations Lead</strong> to own and continuously improve the performance of our insurance verification function. This individual will be accountable for ensuring verifications are completed accurately, efficiently, and in a way that minimizes downstream denials, while operating effectively in a fast-paced, evolving startup environment. This is a hands-on, execution-oriented role with significant autonomy and responsibility.</p><p>&nbsp;</p><p><strong>Core Responsibilities</strong></p><ul><li>Own the day-to-day execution of insurance verification operations, ensuring verifications are completed within required SLAs and prioritized appropriately based on payor&nbsp;behavior, plan complexity, and business urgency.</li></ul><ul><li>Provide functional oversight and guidance to the insurance verification team, ensuring consistent performance, clear prioritization, and adherence to best practices.</li></ul><ul><li>Serve as a subject-matter expert for insurance denials, partnering with external partners to investigate, resolve, and prevent denials related to eligibility, benefits, and&nbsp;authorization errors.</li></ul><ul><li>Perform ongoing quality assurance on verification calls and records, identifying trends, gaps, and training opportunities to continuously improve outcomes.</li></ul><ul><li>Handle complex patient escalations related to insurance coverage, benefits, cost-sharing, and authorization requirements, including direct patient outreach when&nbsp;needed.</li></ul><ul><li>Translate payor-specific nuances, denial patterns, and verification learnings into clear operational guidance for the team.</li></ul><ul><li>Partner closely with cross-functional stakeholders (operations, partnerships, product) to ensure verification processes scale effectively as volume and complexity increase.</li></ul><p>&nbsp;</p><p><strong>Required Experience and Qualifications</strong></p><ul><li>10+ years of experience in insurance verification, prior authorization, and/or revenue cycle management, with deep familiarity across Medicare and Medicare Advantage&nbsp;payors.</li></ul><ul><li>Demonstrated experience overseeing insurance verification functions or teams, including performance monitoring, QA, and process improvement.</li></ul><ul><li>Exceptional technical proficiency, including advanced Excel skills; candidates should expect to complete an Excel-based assessment.</li></ul><ul><li>Deep understanding of payor behavior, denial drivers, and verification best practices, with the ability to apply that knowledge in real-time operational decision-making.</li></ul><ul><li>Comfort working in a startup environment where processes are evolving and ownership is critical.</li></ul><p><br><br></p><p><strong><em>*Note: This is a 1099 contractor position</em></strong></p>

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