Insurance Verification Manager

Overview

The insurance Verification Manager is responsible for leading and optimizing insurance verification operations across supported practices. This role ensures accurate, timely, and compliant insurance eligibility and benefit verification to support point-of-service collections, claim accuracy, and patient experience.

The role includes ownership of vendor-supported and automated insurance verification solutions, including leading implementation, optimization, and adoption of automation tools in partnership with internal teams and external vendors.

Responsibilities

Oversee daily insurance verification activities to ensure eligibility, benefits, and plan details are completed accurately and within required timeframes.

• Establish and enforce standardized verification workflows, documentation requirements, and quality controls.
• Ensure verification processes support accurate treatment estimates, fee presentation, and downstream billing.
• Partner with billing, AR, and operations teams to resolve verification-related issues and prevent denials or rework.
• Lead the implementation of automated insurance verification solutions, including vendor-provided platforms and internal system capabilities.
• Serve as the business owner for automation initiatives, defining requirements, success metrics, and operational workflows.
• Partner with IT, vendors, and operational stakeholders to support system configuration, testing, rollout, and post-implementation optimization.
• Ensure automation tools integrate effectively with practice management systems and existing workflows.
• Monitor automation performance, accuracy, and exception rates; adjust processes to maximize efficiency and quality.
• Lead change management efforts, including training, communication, and adoption support for office and centralized teams.
• Serve as the primary point of contact for third-party insurance verification vendors and automation partners.
• Manage vendor performance against SLAs, turnaround times, accuracy standards, and automation effectiveness.
• Conduct regular vendor performance reviews, including quality audits, reporting analysis, and issue resolution.
• Coordinate onboarding, training, and process updates with vendors to ensure alignment with internal systems and automation strategies.
• Escalate and resolve vendor-related issues impacting office operations, automation performance, or financial outcomes.
• Set performance expectations, monitor productivity and quality metrics, and address gaps through coaching or process improvement.
• Foster a culture of accountability, continuous improvement, and technology adoption.
• Monitor KPIs such as verification timeliness, accuracy, denial prevention, vendor performance, and automation effectiveness.
• Analyze trends to identify opportunities for increased automation, workflow optimization, or vendor enhancements.
• Partner with analytics and RCM leadership to develop dashboards and reporting supporting operational and strategic decisions.
• Lead initiatives to reduce manual effort, improve scalability, and enhance the patient and office experience through automation.
• Ensure verification workflows and automated solutions comply with payer requirements, internal policies, and regulatory standards.
• Partner cross-functionally with IT, Operations, Finance, and Clinical leadership to align automation initiatives with enterprise goals.
• Support system upgrades, vendor transitions, and process changes related to insurance verification and automation.

Qualifications

• Bachelor's degree or equivalent experience in healthcare, business, or revenue cycle management.
• 5+ years of experience in insurance verification, eligibility, or revenue cycle operations.
• 2+ years of people management experience.
• Demonstrated experience managing third-party vendors and/or automated insurance verification solutions.
• Strong understanding of dental insurance plans, eligibility rules, and benefit structures.
• Proven ability to lead change, implement new tools, and drive adoption across teams.