Remote Eligibility & Benefits Operations Manager

Boomerang Healthcare

Walnut Creek (CA)

On-site

USD 87,000 - 104,000

Full time

2 days ago
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Benefits offered by this job

Medical, Dental, Vision benefits (PPO,
401(k) Plan with Employer Matching
License & Tuition Reimbursements
Paid Time Off
Holiday Pay & Floating Holiday
Employee Perks and Discount Programs

Job summary

Boomerang Healthcare is seeking a Manager of Eligibility & Benefits to oversee insurance verification, financial clearance, and point-of-service collection activities across specialties. You will standardize workflows, ensure accurate data entry, and drive revenue retention by ensuring timely patient payments.

This remote role requires leadership in a healthcare revenue cycle and expertise with major payer portals, EHR systems, and Excel-driven analyses to minimize denials and optimize

Qualifications

  • Minimum 5 years of experience in healthcare revenue cycle, patient access, eligibility, benefits, or related experience.
  • Experience with Medicare and commercial insurance plans.
  • Strong understanding of deductibles, copays, coinsurance, out-of-pocket maximums, referrals, prior authorization requirement, coordination of benefits.
  • 2–3 years of direct supervisory or management experience leading healthcare administrative teams.
  • Expert-level understanding of commercial insurance products, including HMO, PPO, and EPO.
  • Advanced proficiency in Microsoft Excel (formulas, pivot tables) and other Office applications.
  • Experience with enterprise-level EHR platforms (Epic, IMS, eClinicalWorks) and integrated payment collection software.

Responsibilities

  • Supervise, train, and schedule eligibility verification and insurance specialist teams.
  • Ensure estimated patient financial responsibility is identified prior to service whenever information is available.
  • Communicate expected copays, deductibles, coinsurance, and other patient responsibility clearly.
  • Establish escalation procedures for high-dollar patient responsibility or benefit limitations.
  • Oversee eligibility verification workflows across diverse clinical lines (specialty to high-cost surgery/diagnostics).
  • Analyze denial data with billing/coding teams and implement root-cause fixes for eligibility-related denials.
  • Serve as primary administrator for major payer portals (Availity, Optum, UnitedHealthcare, Anthem).
  • Assume other responsibilities as appropriate.

Skills

Leadership
Process improvement
Payer knowledge
EHR proficiency
Excel skills
Communication

Tools

Epic
IMS
eClinicalWorks

Job description

Boomerang Healthcare is seeking a Manager of Eligibility & Benefits to oversee insurance verification, financial clearance, and point-of-service collection activities across specialties. You will standardize workflows, ensure accurate data entry, and drive revenue retention by ensuring timely patient payments.

This remote role requires leadership in a healthcare revenue cycle and expertise with major payer portals, EHR systems, and Excel-driven analyses to minimize denials and optimize

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