US Healthcare Coding Validation- Operations Manager

US HEALTHCARE CODING VALIDATION - OPERATIONS MANAGER

PRINCIPLE PURPOSE OF JOB

We are currently seeking an Operations Manager to support a growing client base and manage the day-to-day operational activities of the production team and to help stabilization of the process combining their clinical and/or coding expertise with payment accuracy. This includes ensuring that the team delivers as per set expectations while maintaining the required quality standards. The role involves day to day coordination with internal as well external teams.

JOB RESPONSIBILITIES

• Supervise the day-to-day operations and effectively manage a team of production analysts/Team Leads on the assigned project
• Ensure team delivers 100% on projects within contracted turn-around-time and meets accuracy metric as per client SLA
• Ensure optimum utilization of the staff and manage shrinkage to meet daily deliverables
• Identifying the areas of improvement for training for a team/individual based on error trend analysis
• Effective planning in place to manage OJT period within the specified period
• Support the team by discussing complex cases, resolving queries, providing education and interfacing with both company and client leadership
• Steer internal education program to ensure team has required training to meet accuracy and turn-around-time metric
• Ensures proactive identification of any negative deviations in the process
• Contribute to PCI product by providing feedback to Management/Development Teams on changes to enhance editing and efficiency.
• Willing to work in a 24*7 work environment post training
• Training would be conducted during US business hours
• Required to be available in the office for training and first few weeks of go-live, depending on the future pandemic conditions as well as company’s ability to resume operations from an office setting
• Works effectively in co-ordination with the India team

ATTRIBUTES AND BEHAVIORS

• Develops and maintains positive working relationships with others
• Shares ideas and information and has ability to collaborate efficiently
• Assists colleagues and the team unprompted
• Takes pride in the achievement of team objectives
• Has credibility with peers and senior managers
• Self-motivated – driven to achieve results
• Works with a sense of urgency
• High customer service ethic – is passionate about meeting customer expectations and improving service levels
• Keeps pace with change – acquires knowledge/skills as the business evolves
• Handles confidential information with sensitivity

RELEVANT EXPERIENCE & EDUCATIONAL REQUIREMENTS

• Registered Nurse with CPC/COC certification
• Minimum of two years’ experience working as Asst. Mgr./Mgr. or equivalent
• Experience in US Healthcare, medical coding, medical billing, RCM health plan operations strongly preferred
• Possesses knowledge of healthcare claims payment policy and processing – specifically CMS, Medicaid regulations, AAOS, ICD-10, CPT & HCPCS, etc.
• Practical clinical experience working in a hospital/office or nursing home
• Has general knowledge of medical procedures, conditions, illnesses, and treatment practices
• Possesses excellent written and verbal communication skills. Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency
• Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.

SKILLS & COMPETENCIES

• Strong analytical, critical thinking and problem-solving skills
• Excellent verbal and written communication skills
• Quick learner and proficient in application of learnings
• Excel proficiency
• Strong organizational skills and adaptive capacity for rapidly changing priorities and workloads
• Able to get periodic analysis as per business needs, to improve productivity and quality
• Ability to work well independently and maintain focus on a topic for prolonged periods of time