Billing Operations Manager – Eligibility/ Verification Authorization at Caris Life Sciences

Royal Oak, Michigan, United States -

Full Time

Start Date

Immediate

Expiry Date

07 Feb, 26

Salary

0.0

Posted On

09 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Healthcare Billing Operations, Insurance Verification, Prior Authorizations, Benefit Assessments, Revenue Cycle Management, CPT Coding, ICD-10 Coding, HCPCS Coding, Payer Regulations, Team Leadership, Process Improvement, Training and Development, Data Analysis, HIPAA Compliance, Problem Solving, Interpersonal Skills

Industry

Biotechnology Research

Description

At Caris, we understand that cancer is an ugly word—a word no one wants to hear, but one that connects us all. That’s why we’re not just transforming cancer care—we’re changing lives. We introduced precision medicine to the world and built an industry around the idea that every patient deserves answers as unique as their DNA. Backed by cutting-edge molecular science and AI, we ask ourselves every day: “What would I do if this patient were my mom?” That question drives everything we do. But our mission doesn’t stop with cancer. We're pushing the frontiers of medicine and leading a revolution in healthcare—driven by innovation, compassion, and purpose. Join us in our mission to improve the human condition across multiple diseases. If you're passionate about meaningful work and want to be part of something bigger than yourself, Caris is where your impact begins. Position Summary Caris Life Sciences is seeking a full-time Billing Operations Manager to lead and manage the Eligibility function within our Billing Operations team. This role is responsible for overseeing the daily operations of the Eligibility team and ensuring timely and accurate verification of patient benefits. This role plays a critical part in supporting revenue cycle efficiency and patient access by ensuring that insurance eligibility processes are compliant, efficient, and patient-focused. The Eligibility Manager provides leadership, training, and performance management to staff, while partnering cross-functionally to optimize workflows and resolve payer issues. Job Responsibilities Lead and manage the Eligibility team, ensuring accurate and timely insurance verification, prior authorizations, and benefit assessments. Develop and monitor team performance metrics, ensuring goals are met for turnaround time, accuracy, and payer compliance. Collaborate with payers to resolve eligibility discrepancies, denials, and escalations. Work closely with Revenue Cycle leadership to identify trends, gaps, and opportunities for process improvements. Implement and update policies and procedures to ensure compliance with regulatory and payer requirements. Train, coach, and mentor team members to enhance knowledge of payer guidelines, systems, and best practices. Partner with cross-functional teams Billing to support a seamless patient and provider experience. Provide regular reporting and analysis of eligibility performance, including KPIs, denial trends, and payer turnaround times. Manage staffing schedules, workload distribution, and productivity standards to ensure operational coverage and efficiency. Support system implementations, testing, and enhancements related to eligibility processes. Provide strategic direction, coaching, and professional development to foster a high-performance culture. Lead by example and promote a culture of accountability and continuous improvement. Identify and implement process enhancements to improve efficiency, reduce error rates, and support scalability. Standardize procedures and documentation across the department. Evaluate and implement technology solutions and reporting tools to support automation and performance tracking. Ensure adherence to HIPAA, payer rules, and all relevant state and federal regulations. Stay current on industry best practices, regulatory updates, and payer changes impacting billing and date of service requirements. Required Qualifications High School diploma or equivalent required; 5–7 years of experience in healthcare billing operations, with at least 2–3 years in a supervisory or management role. Strong knowledge of CPT, ICD-10, HCPCS coding, payer regulations, and revenue cycle management. Ability to lead cross-functional initiatives and manage timelines, resources, and deliverables. Experience with Medicare Advantage plans and familiarity with Xifin is a plus. Demonstrated ability to lead teams, manage change, and drive performance in a fast-paced environment. Proficiency in Microsoft Office Suite (Excel, Word, Outlook, Access) and healthcare billing systems. Strong interpersonal, communication, and problem-solving skills. Preferred Qualifications Bachelor’s degree in Business, Healthcare Administration, or related field. Familiarity with lab workflows and integration with billing systems. Experience with Data Analytics Tools Ability to navigate diverse payer requirements and regulatory environments. Proven ability to lead teams through organizational or system transitions. Experience in Precision Medicine or Oncology Billing Focus on service, quality, and continuous improvement. Ability to analyze complex issues and develop effective solutions. Work effectively across departments to achieve shared goals. Understand and exceed internal and external client expectations. Thrive in a dynamic environment with evolving priorities. Physical Demands Ability to sit and/or stand for extended periods. Perform repetitive motions and lift up to 15 pounds. Majority of work performed in a desk/cubicle environment. Training All job specific, safety, and compliance training are assigned based on the job functions associated with this employee. Other This position may require some evenings, weekends and/or holidays. Conditions of Employment: Individual must successfully complete pre-employment process, which includes criminal background check, drug screening, credit check ( applicable for certain positions) and reference verification. This job description reflects management’s assignment of essential functions. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Caris Life Sciences is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability. Caris Life Sciences is a leading innovator in molecular science and artificial intelligence focused on fulfilling the promise of precision medicine through quality and innovation. Caris is committed to quality and excellence at our state-of-the-art laboratories. Learn more about our tissue lab and the advanced technologies that are helping improve the lives of cancer patients.

Responsibilities

The Billing Operations Manager will lead and manage the Eligibility team, ensuring accurate and timely insurance verification and benefit assessments. This role is critical in supporting revenue cycle efficiency and patient access by optimizing workflows and resolving payer issues.