Supervisor, Insurance Analyst
$65,500–$125,500 year
HybridNorth Chicago, Illinois, United States
Job Summary
Supervise and oversee insurance analysts responsible for verifying new patient insurance benefits, handling claim rejections, and resolving prior authorization and denied coverage requests. Partner with leads to monitor workflow, adjust staffing, and coach staff on performance metrics, attendance, and hiring processes. Monitor calls, perform case reviews, and provide periodic progress reports on goals and local payor intelligence to management. Identify process improvements to increase operational efficiencies and implement new projects within the Pharmacy team. Ensure compliance with federal, state, and local pharmacy laws, HIPAA, and privacy policies while maintaining a seamless customer experience for physicians and patients.
Required Qualifications
- Bachelor's degree or Associate Degree in health sciences or business
- 3-5 years of experience in the healthcare industry with knowledge in reimbursement, billing, prior authorization, appeals, and specialty pharmacy operations
- 1-2 years supervisory experience in a call center, large physician, managed care, or healthcare insurance setting
- Demonstrated strong, accurate technical skills
- Must be detail oriented
- Must have a thorough understanding and knowledge of commercial and government pharmacy and medical insurance programs, billing, alternate funding resources, reimbursement processes, prior authorization and appeal filings, and specialty pharmacy operations
- Proven leadership and coaching skills
- Demonstrated ability to lead and participate within a team, manage multiple priorities and meet associated timelines while maintaining accuracy
- Must have professional written and verbal communication skills to interact with and build and maintain relationships with all levels of the organization
- Must maintain a positive service image at all times even when dealing with challenging issues and unsatisfied customers
- Proven organizational, time management, and problem solving skills
- Skilled with the use of the Microsoft Office suite and the ability to use and effectively learn and navigate other computer systems
Desired Qualifications
- Comparable or relevant experience will be considered
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