Medical Insurance Manager

Description:

We are seeking an experienced Medical Insurance Manager to lead our medical insurance department. This role focuses on ensuring compliance, managing insurance provider relationships, and optimizing claims processes for maximum efficiency and revenue generation.
Key Responsibilities:
✅ Oversee daily operations of the medical insurance department, ensuring legal and regulatory compliance.
✅ Manage insurance provider relationships, negotiate contracts, and secure favorable terms.
✅ Review and approve insurance claims for accuracy and completeness before submission.
✅ Track and analyze reimbursement trends to identify improvement opportunities.
✅ Verify patient insurance coverage and resolve discrepancies.
✅ Collaborate with billing and finance teams to streamline claims processing.
✅ Monitor patient accounts for timely insurance payments and address outstanding claims.
✅ Stay informed about healthcare regulations and industry trends.
✅ Provide staff training on insurance policies, procedures, and claims management.
✅ Prepare detailed insurance performance reports on claims, denials, and reimbursements.
✅ Manage escalated claim denials or appeals with insurance companies and patients.
✅ Develop strategies to optimize insurance revenue and minimize claim denials.
What We’re Looking For:
🎓 Education: Bachelor’s degree in Healthcare Management, Business Administration, or a related field.