IVS/ Authorizations Manager
CardioRev
05.2021 - Current
- Direct end-to-end prior authorization, insurance verification, and referral workflows for 20+ cardiology providers, ensuring timely submission, renewal, and follow-up on every request.
- Analyze denial and QA audit data across 100+ monthly cases to surface clinical-relevance and accuracy trends, introducing targeted verification workflows that significantly reduced front-end billing denials.
- Build and maintain advanced Excel-based backlog, productivity, and payer-behavior trend reports, translating data into actionable workload and staffing decisions for leadership.
- Partner cross-functionally with clinical and billing teams to manage the authorization lifecycle from receipt of clinical records through final determination, scaling operations during high-volume surges.
- Provide structured onboarding and ongoing coaching for direct reports, reducing new-hire ramp time and strengthening team performance against productivity metrics.
- Resolve complex escalations involving coverage, benefits, and appeals, avoiding delays in patient care and protecting revenue.