Senior Manager, Insurance Operations

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Tru Hearing is a rewarding, fun and friendly, mission-based organization that makes a real difference towards improving people’s lives. Our employees enjoy a positive working environment in a company that has experienced rapid growth. We offer a comprehensive benefits package, educational assistance, and opportunities for advancement.

Tru Hearing is the market leader and a force for positive change in the hearing healthcare industry. We reconnect people to the richness of life through industry-leading hearing healthcare solutions. We work with insurance companies, hearing aid manufacturers, and healthcare providers to reduce prices and expand access to better hearing care and whole-body health.

Tru Hearing is part of the WS Audiology Group (WSA), a global leader in the hearing aid industry. Together with our 12,000 colleagues in 130 countries, we invite you to help unlock human potential by bringing back hearing for millions of people around the world. The WSA portfolio of technologies spans the full spectrum of hearing care, from distinct hearing brands and digital platforms to managed care, hearing centers and diagnostics locations.

The purpose of this role is to drive results for the insurance team by overseeing daily operations, developing both direct and indirect reports, and leading or supporting key departmental and company initiatives. These initiatives typically focus on scalability, growth, and efficiency in areas such as benefit verification, claims workflows and recovery, and billing activities.

• Engage with payer partners’ leadership teams to resolve complex insurance claim issues and develop systems designed to avoid future issues.
• End-to-End Revenue Cycle Management Oversight:
  Ensure accurate and timely benefit verification, claims submission, adjudication, and payment posting and collection. Partner with Accounting Department to resolve outstanding account receivable issues related to health insurance claims and identify processes to minimize such issues.
• Cash Flow Optimization:
  Monitor and improve days in accounts receivable, ensuring timely collections and reconciliation.
• OON Claim Lifecycle Management:
  Oversee end-to-end processing of out-of-network claims, including benefit verification, pricing, submission, and adjudication. Resolve complex OON claim disputes with payers and patients, including appeals and arbitration processes.
• Ensure team is accurately and timely verifying member benefits and processing/adjudicating both in-network and out-of-network claims.
• Work directly with external and internal audit teams, responding to audit requests and ensuring claims adjudication accuracy.

• Facilitate day-to-day management, and new implementations within the Insurance Operations technology suite (QNTX/Cognizant, Waystar, Trizetto, Availity, Echo, etc.)
• Own, document, and keep current insurance processes, procedures, policies, and training materials.
• Drive innovation and creativity inside of insurance team.
• Exemplify true subject matter expertise regarding insurance and identify ways to develop other personnel as additional experts.
• Partner with department leadership to identify objectives and outcomes for the insurance team.
• Drive for results with measurable improvement in employee retention and satisfaction in collaboration with department leaders and HR leadership; build and cultivate a culture of trust, accountability, and engagement within the insurance team.

• Successfully lead/participate in client and vendor-facing activities when requested to present needs and solutions related to insurance functions.
• Build strong relationships inside and outside of the insurance department; respond timely and thoughtfully with all stakeholders to support positive interdepartmental cooperation.

• Develop forecasting analysis to identify staffing needs and ensure required staffing…