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Recora · 19 hours ago

Insurance Verification Operations Lead

United States

Full-time

Remote

Senior Level, Lead/Staff

$35/hr - $35/hr

10+ years exp

Recorainc is a startup focused on improving insurance verification processes, and they are seeking an Insurance Verification Operations Lead. This role involves overseeing the insurance verification function, ensuring accuracy and efficiency in verifications, and minimizing downstream denials while working in a fast-paced environment.

Health CareHospital

Responsibilities

Own the day-to-day execution of insurance verification operations, ensuring verifications are completed within required SLAs and prioritized appropriately based on payor behavior, plan complexity, and business urgency

Provide functional oversight and guidance to the insurance verification team, ensuring consistent performance, clear prioritization, and adherence to best practices

Serve as a subject-matter expert for insurance denials, partnering with external partners to investigate, resolve, and prevent denials related to eligibility, benefits, and authorization errors

Perform ongoing quality assurance on verification calls and records, identifying trends, gaps, and training opportunities to continuously improve outcomes

Handle complex patient escalations related to insurance coverage, benefits, cost-sharing, and authorization requirements, including direct patient outreach when needed

Translate payor-specific nuances, denial patterns, and verification learnings into clear operational guidance for the team

Partner closely with cross-functional stakeholders (operations, partnerships, product) to ensure verification processes scale effectively as volume and complexity increase

Qualification

Insurance verificationRevenue cycle managementProcess improvementAdvanced ExcelPayor behavior knowledgeTeam oversightQuality assurancePatient communicationStartup adaptability

Required

10+ years of experience in insurance verification, prior authorization, and/or revenue cycle management, with deep familiarity across Medicare and Medicare Advantage payors

Demonstrated experience overseeing insurance verification functions or teams, including performance monitoring, QA, and process improvement

Exceptional technical proficiency, including advanced Excel skills; candidates should expect to complete an Excel-based assessment

Deep understanding of payor behavior, denial drivers, and verification best practices, with the ability to apply that knowledge in real-time operational decision-making

Comfort working in a startup environment where processes are evolving and ownership is critical