Senior Manager, Insurance Operations

Insurance Manager

About Tru Hearing. Tru Hearing is a rewarding, fun, and friendly, mission‑based organization that makes a real difference toward improving people’s lives. Our employees enjoy a positive working environment in a fast‑growing company. We offer a comprehensive benefits package, educational assistance, and opportunities for advancement.

The purpose of this role is to drive results for the insurance team by overseeing daily operations, developing both direct and indirect reports, and leading or supporting key departmental and company initiatives focused on scalability, growth, and efficiency in benefit verification, claims workflows and recovery, and billing activities.

• Engage with payer partners’ leadership teams to resolve complex insurance claim issues and develop systems to avoid future problems.
• End‑to‑End Revenue Cycle Management Oversight: ensure accurate and timely benefit verification, claims submission, adjudication, payment posting, and collection. Partner with Accounting to resolve outstanding receivable issues and identify processes to minimize them.
• Cash Flow Optimization: monitor and improve days in accounts receivable, ensuring timely collections and reconciliation.
• OON Claim Lifecycle Management: oversee end‑to‑end processing of out‑of‑network claims, including benefit verification, pricing, submission, and adjudication. Resolve complex OON disputes with payers and patients, including appeals and arbitration processes.
• Ensure team accurately verifies member benefits and processes/adjudicates both in‑network and out‑of‑network claims.
• Work directly with external and internal audit teams, responding to audit requests and ensuring claims adjudication accuracy.

• Facilitate day‑to‑day management and new implementations within the Insurance Operations technology suite (QNTX/Cognizant, Waystar, Trizetto, Availity, Echo).
• Own, document, and keep current insurance processes, procedures, policies, and training materials.
• Drive innovation and creativity inside the insurance team.

• Exemplify subject‑matter expertise regarding insurance and develop other personnel as additional experts.
• Partner with department leadership to identify objectives and outcomes for the insurance team.
• Drive measurable improvement in employee retention and satisfaction, building a culture of trust, accountability, and engagement.

• Lead or participate in client and vendor‑facing activities to present needs and solutions related to insurance functions.
• Build strong relationships inside and outside the department; respond timely and thoughtfully to support positive inter‑departmental cooperation.

• Develop forecasting analysis to identify staffing needs and ensure required staffing is in place through partnerships with Workforce Management, Human Resources, and Finance Departments.
• Create, implement, and measure the effectiveness of initiatives and related incentive plans through tracking metrics and custom reports.

In addition to exhibiting the Tru Hearing values of Delight, Align, Enjoy, Improve, and Be Tru
, this role requires the following:

• Managing People – build, manage, and motivate diverse teams to accomplish goals within policies and procedures.
• Teamwork – coach others to contribute as a team and remove barriers to teamwork.
• Productivity – help others meet and exceed productivity standards.
• Quality – review and coach others on quality standards.
• Problem Solving – connect solvers from varying expertise to solve complex or timely problems.
• Influence & Persuasion – craft persuasive messages and collaborate effectively to impact business.
• Accountability – hold others accountable to performance, policy, and behavioral standards.
• Initiative – inspire and empower others to act.
• Decision Making – coordinate others to make significant or complex decisions.
• Subject Matter Expertise – leverage expertise to expose opportunities and grow expertise in others.
• Planning & Organizing – coordinate others to…