Insurance Utilization Review Jobs in Trumbull, CT

The Team Lead will oversee key components of the revenue cycle including Internal and Outsourced Billing Services and Financial & Insurance Assistance.  Serves as the organization’s internal lead for oversight of both outsourced billing vendor and internal patient billing activities, including self-pay and sliding fee accounts.

This role ensures patients have timely access to insurance enrollment and financial assistance services while maintaining strong internal controls, accurate patient billing processes, vendor accountability, and compliance with healthcare billing and payer requirements.

ESSENTIAL JOB RESPONSIBILITIES:

Revenue Cycle Oversight:

• Serve as the primary internal liaison between CIFC Health and the outsourced billing vendor.
• Monitor revenue cycle performance metrics, including claim submission timeliness, denial trends, accounts receivable aging, and collections.
• Review billing and financial reports to identify discrepancies, trends, or compliance concerns.
• Coordinate escalation, issue resolution, and corrective actions with the billing vendor and internal stakeholders.
• Collaborate with Accounting, Front Desk, and Clinical leadership to ensure workflows support accurate and compliant revenue capture.
• Ensure posting and reconciliation of insurance payments are completed timely in accordance with policies.
• Support audits, payer reviews, and compliance activities related to outsourced billing and revenue cycle functions.

Internal Billing Oversight: 

• Oversee internal billing processes for self-pay, sliding fee, and other non-insurance patient accounts.
• Ensure accurate patient statements, payment posting, adjustments, and account follow-up for internally billed accounts.
• Monitor self-pay balances, payment plans, and collections activity to support patient access while maintaining financial stewardship.
• Work collaboratively with the FIA team, Front Desk, and Accounting to ensure consistency between eligibility determinations and patient billing.
• Identify trends or issues related to self-pay billing and recommend process improvements.
• Ensure internal billing practices align with CIFC Health policies, compliance standards, and patient-centered care principles.

Financial & Insurance Assistance (FIA) Team Leadership:

• Provide direct supervision, coaching, and support to the Financial & Insurance Assistance team.
• Ensure efficient, compliant access to: 
  • Medicaid, ACA,  and State of Connecticut insurance programs
  • Sliding Fee Discount Program eligibility
  • Patient payment plans and financial counseling
• Ensure consistent and compliant eligibility determinations and documentation practices.
• Monitor staff schedules to maximize patient access to financial and insurance assistance services.
• Oversee patient payment processing, internal financial reconciliation activities, and reporting.
• Communicate CIFC Health policy updates and ensure staff compliance.
• Promote respectful, compassionate, and professional patient interactions.

Key Performance Expectations:

• Improve clean claim rate and reduce denial trends
• Reduce accounts receivable aging
• Increase insurance enrollment and sliding fee utilization
• Improve patient collections and self-pay recovery
• Maintain audit readiness and regulatory compliance

 QUALIFICATIONS:

• Fluency in English required; Spanish and/or Portuguese strongly preferred
• Strong leadership, analytical, and problem-solving skills
• Ability to interpret revenue cycle and patient billing reports
• Experience working effectively with diverse populations

EDUCATION and/or EXPERIENCE:

• Minimum 4 years of experience in medical billing
• Minimum 2 years of supervisory or team leadership experience
• Bachelor’s degree required or equivalent relevant work experience
• At least 2 years of experience in healthcare financial assistance, insurance enrollment, patient billing, collections, or revenue-related operations
• Experience in community health centers, FQHCs, or healthcare settings preferred
• Proficiency in Microsoft Word, Excel, and Outlook

KNOWLEDGE AND ABILITIES:

• Knowledge of healthcare revenue cycle operations and patient billing practices
• Understanding of self-pay, sliding fee, and insurance-based billing workflows
• Strong attention to detail, accuracy, and compliance
• Ability to manage vendor relationships and internal billing processes simultaneously
• Excellent organizational, communication, and time-management skills
• Ability to handle confidential patient and financial information appropriately

Benefits:

Competitive compensation commensurate on experience.  Comprehensive fringe benefits package including health care coverage and retirement program.  CIFC Health is a NACHC and a PSLF approved site, eligible for the submission of loan forgiveness applications.  13-paid holidays in addition to paid time-off, Monday-Friday day-shift schedule.  Mission-focused environment.

Closing Date: Open Until Filled

Compensation details: 65000-80000 Yearly Salary

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