Operations Manager

Reports to (level of category): Senior Operations Manager

Role Objective

Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash posting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company.

Essential Duties and Responsibilities

• Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures.
• Day-to-day operations
• People Management (Work Allocation, On job support, Feedback & Team building)
• Performance Management (Productivity, Quality, One-On-One sessions, KRA, PIP)
• Reports (Internal and Client performance reports)
• Work allocation strategy
• CMS 1500 & UB04 AR experience is mandatory.
• Span of control - 80 to 100
• Thorough knowledge of all AR scenarios and Denials
• Expertise in both Federal and Commercial payor mix
• Excellent interpersonal skills
• Should be capable to interact with US clients and manage escalations

Qualifications

• Graduate in any discipline from a recognized educational institute
• Good analytical skills and proficiency with MS Word, Excel and PowerPoint
• Good communication Skills (both written & verbal)

Skill Set

• Candidate should be good in Denial Management
• Candidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials.
• Ability to interact positively with team members, peer group and seniors.
• Demonstrated ability to exceed performance targets.
• Ability to effectively prioritize individual and team responsibilities.
• Communicates well in front of groups, both large and small.