DescriptionPosition Title: Director of Insurance Verifications
Location: REMOTE
Entity: Alliance Health System
Reports To: Senior Vice President of Revenue Cycle Management
Director of Insurance Verifications
As the Director of Insurance Verification, you will provide strategic and operational leadership for the insurance verification function, ensuring accuracy, scalability, and compliance across the organization. This role oversees domestic and offshore verification teams, drives process optimization across the revenue cycle, and partners cross-functionally to reduce denials, improve cash flow, and enhances the patient financial experience. The Director is accountable for aligning verification operations with organizational growth, regulatory requirements, and best-in-class revenue cycle performance.
Key Responsibilities
Strategic Leadership & Governance
- Establish and execute the enterprise-wide strategy for insurance verification, aligning departmental goals with broader revenue cycle and organizational objectives.
- Provide executive-level leadership to verification teams, including managers, supervisors, and offshore partners, fostering a culture of accountability, performance excellence, and continuous improvement.
- Define and govern policies, controls, and performance standards for insurance verification operations.
- Serve as the senior escalation point for complex payer, eligibility, and authorization issues, ensuring timely resolution and minimal revenue impact
- Lead workforce planning, capacity modeling, and organizational design to support volume growth and operational scalability.
Operational Excellence
- Oversee end-to-end insurance verification activities, ensuring accuracy, timeliness, and consistency across all patient access channels.
- Drive standardization and optimization of workflows, SOPs, and quality assurance processes across onshore and offshore teams.
- Partner closely with Patient Access, Billing, Coding, Call Center, and Finance leaders to ensure seamless handoffs and alignment across the revenue cycle.
- Establish and monitor key performance indicators (KPIs) such as eligibility accuracy, authorization turnaround time, denial prevention, and productivity metrics.
- Leverage data and reporting to identify trends, mitigate risk, and improve operational outcomes.
Process Improvement, Technology & Compliance
- Lead continuous improvement initiatives to reduce verification-related denials, rework, and patient friction.
- Evaluate and optimize the use of EHR systems, payer portals, automation tools, and emerging technologies to improve efficiency and accuracy
- Stay current on payer rules, reimbursement trends, and regulatory requirements, ensuring organizational compliance with HIPAA and industry standards.
- Own audit readiness and compliance monitoring related to insurance verification and patient financial data.
- Develop enterprise training frameworks, competency models, and documentation to support onboarding and ongoing development.
Financial & Patient Experience Impact
- Drive measurable improvements in cash flow, denial reduction, and upfront financial clarity for patients
- Collaborate with leadership to support transparent patient communication regarding coverage, benefits, and financial responsibility.
- Ensure verification practices support a positive, consistent, and compliant patient experience
Qualifications & Experience
- Education: Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field preferred; equivalent experience considered
- 7+ years of progressive experience in insurance verification, patient access, or revenue cycle operations.
- 3+ years in senior leadership roles with responsibility for multi-site or offshore teams.
- Revenue Cycle Expertise: Deep knowledge of insurance verification, payer rules, authorizations, CPT/ICD coding, EHR systems, and denial prevention
- Leadership & Strategy: Proven ability to lead large, distributed teams and drive operational transformation at scale.
- Analytical Skills: Strong ability to use data, KPIs, and financial metrics to inform decisions and measure impact
- Communication: Executive-level communication and stakeholder management skills, with the ability to influence across departments
- Compliance & Risk Management: Strong understanding of HIPAA and healthcare regulatory standards.
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