Assistant Manager - Medical Operations

Job Description

Role & responsibilities Create an efficient work environment by fostering strong communication across medical staff and non-medical staff. Provide management, organization, and coordination of day to day work in medical operations. Ensure new processes and procedures are implemented and used effectively by the team. Ensure a high level of knowledge within the teams as evidenced through turnaround time of issues and ability to resolve issues independently. Act as liaison with medical services, billing, front office & MRD departments to ensure customer objectives are being met and complaints are resolved. Maintain confidentiality regarding patient status/treatment and other sensitive hospital operations. Represent Hospital for all medico-legal issues. Responsible for maintaining and implementing Patient Feedback Process and conduct regular patient feedback analysis. Regular audits to be done in MRD for continuous data update & timely data availability. Coordinate with different departments in queries raised regarding medical records & get it resolved with the help of MRD team. Taking daily rounds understand issues of patients on floor & prepare plan of action to resolve their queries, in coordination with respective departments. Analyze the significant data collected from patients to make necessary changes in plan of care & for smooth patient care right from admission to discharge. Handling patients / relative queries in emergency situations along with respective staff in department. Manages TPA staff with service/claims processing team members. Ensure timely, quality service and customer satisfaction by establishing and communication service metrics/expectations, monitoring results, evaluating trends, coaching/developing staff. Coordinate for processing the Cashless Claims for different Insurance And TPA Companies along with billing department & patient. Coordinating between Insurance Company, TPAs & patients related to Medical Cashless Claims. Guidance & Counseling to the patients regarding how Cashless facilities work in their respective insurance. Answering for the Queries medical Queries, non-Medical Queries to patients & their relative for getting medical insurance done. Following the Policy terms and conditions of respective insurance companies. Clarifying the clients Queries related to cashless claims. Verifying the Pre-authorization Forms and Discharge Summary for Possible Approval. Finally settlements of Claims as per policy terms and conditions. Responsible for supervising day to day activities of Medical Record Department. Responsible to follow SOPs that have been laid down by the management Any other task assigned by HOD Qualification: BDS, BAMS or BHMS with MBA or MHA Experience: 5-8 years of hospital experience Interested Candidate can share your profile to people.hr@vrhpune.com