Supervisor, Insurance Analyst

Job Description The Supervisor, Insurance Analyst provides leadership, support, and supervision for the Insurance Analyst team. This individual is a subject matter expert on commercial pharmacy, major medical, and government insurance plans, prior authorizations, appeals, and alternate coverage referrals. The supervisor ensures that all day to day activities of the team operate smoothly and seamlessly to provide the best customer experience for physician offices and ultimately patients. This position is responsible for ensuring all performance metrics, workload deliverables and customer services activities are completed in alignment with a high touch business model. Responsibilities Supervise and oversee insurance analysts responsible for verifying new patient insurance benefits and handling claim rejections. Work proactively with staff and cross-functional groups to develop creative solutions to challenging patient access issues regarding prior authorization, and denied coverage requests to ensure patient care. Partner with Leads to monitor work flow and adjust workload and staffing requirements to ensure that all activities are addressed in a timely and efficient manner. Monitor calls and perform case reviews to ensure accuracy of information, adherence to policies, and excellent customer service. Provide additional coaching and training to individuals as needed; meet regularly with direct reports to provide direct feedback on their performance and progress against goals; write and communicate performance reviews. Perform administrative tasks such as work hour scheduling, attendance monitoring, counseling, vacation request scheduling, and overtime scheduling. Participate in the hiring process and handle all employee issues for direct reports. Use effective coaching and management techniques to maintain a highly motivated and interactive work staff. Meet or exceed department standards relative to performance metrics; provide periodic progress reports on goals and metrics; provide activity metrics, status updates, and local payor intelligence information to management per guidelines; elevate issues as appropriate. Consistently build and maintain collaborative relationships cross-functionally to ensure a seamless customer experience for patients and physicians. Identify process improvements to increase operational efficiencies; develop action plans for execution; assist with implementation of new projects and products within the Pharmacy. Understand and comply with all required training, including adherence to applicable federal, state, and local pharmacy laws, HIPAA, privacy policies and guidelines, and the policies and procedures of the business. Perform additional tasks, activities, and projects as deemed necessary by management. Qualifications Bachelors degree or Associate Degree in health sciences or business preferred. Comparable or relevant experience will be considered. 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 desired. Demonstrated strong, accurate technical skills. Must be detail oriented. Must have 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, elevating to management when appropriate. Skilled with the use of the Microsoft Office suite and the ability to use and effectively learn and navigate other computer systems. Additional Information The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of this posting based on the job grade for this position. Individual compensation paid within this range will depend on many factors including geographic location, and we may ultimately pay more or less than the posted range. This range may be modified in the future. We offer a comprehensive package of benefits including paid time off (vacation, holidays, sick), medical/dental/vision insurance and 401(k) to eligible employees. This job is eligible to participate in our short-term incentive programs. Equal Opportunity Employer AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled. Reasonable Accommodation US & Puerto Rico applicants seeking a reasonable accommodation, click here to learn more: #J-18808-Ljbffr BioSpace, Inc.