Manager, Insurance Coordinators

Company Overview

Summit Spine and Joint Centers (SSJC) is on track to become the largest comprehensive spine and joint care provider in the Southeast while providing clinical and surgical services to our patients. We excel in providing quality care to all our patients and are trend setters in the field with our multi-modality treatment options and varied care delivery models. We are seeking qualified individuals to join our team and provide exceptional patient care!

We are seeking a highly motivated and experienced Manager of Insurance Verification and Authorization to lead and mentor our team of insurance coordinators. The successful candidate will oversee the daily operations of both Insurance Verification and Insurance Authorization Specialists, ensuring efficient, accurate, and timely processing of patient insurance information. This role requires a leader with strong problem‑solving skills and in‑depth knowledge of the healthcare revenue cycle.

This job is a full‑time, benefited position at Summit Spine & Joint Centers that reports to the Administrative Operations Director.

• Team Management:
  Manage, train, and mentor a team of Insurance Verification and Authorization Specialists, fostering a culture of teamwork, high performance, and continuous improvement.
• Operational Oversight:
  Develop, implement, and monitor workflows and protocols for all insurance verification, authorization, and referral processes to maximize efficiency and accuracy.
• Performance Monitoring:
  Set and track key performance indicators (KPIs) for the team, including authorization success rates, denial rates, and turnaround times. Provide regular reports to senior management.
• Escalation Management:
  Serve as the primary point of contact for resolving complex insurance issues, discrepancies, and difficult authorization cases.
• Quality Assurance:
  Conduct regular audits of patient accounts to ensure all information, including eligibility, benefits, and pre‑authorizations, is accurately documented.
• Carrier Relations:
  Maintain effective communication and build strong relationships with various insurance carriers and third‑party payers.
• Compliance:
  Ensure the team's strict adherence to all internal policies, as well as state and federal regulations, including HIPAA.
• Training & Development:
  Identify training needs and organize ongoing education for the team on new insurance policies, procedures, and software systems.
• Process Improvement:
  Identify and implement opportunities for process improvements and system enhancements to streamline the verification and authorization process.
• Other Insurance duties as assigned.

• Must be personable and detail oriented as a representative of the practice while callers rely on proper information.
• Excellent verbal and written skills for proper documentation of encounters.

• Minimum of 4 years' experience in an outpatient medical office, working in an Insurance Verification/Authorization.
• Experience as a manager of Insurance Coordination preferred.
• Excellent knowledge of CPT coding, ICD.
  10 coding and medical pre‑certification protocols required.
• Authorization portal experience required.
• Experience in Pain Management Authorizations required.
• EMR/EHR experience is required.