Project Manager- US Medical Billing (Benefit Verification)

Role / Designation: Project Manager

Years of Experience: 10-12 years of relevant experience in Client Facing roles in Healthcare Services; Preferably in the role of a Medical billing/claims Manager

Education Qualifications: Engineering Degree / Masters Degree / Bachelors Degree

Job Location: Vizag & Shillong

Other requirements: Ability to travel between iMerit offices up to 25%

Job Summary:

We are currently in search of a highly experienced and dynamic Project Manager to assume responsibility for one of our most significant healthcare clients. In this pivotal role, you will be tasked with overseeing a team of Operators and Reviewers, with a primary focus on optimizing operational efficiency and maintaining the highest standards of accuracy and quality. Collaboration with cross-functional teams, vigilant monitoring of performance metrics, and driving initiatives for continuous improvement will be key components of this role. The ideal candidate will possess exceptional leadership skills, a deep knowledge of the healthcare industry, and the ability to inspire and motivate a large team towards the achievement of our organizational objectives.

Responsibilities will include but not limited to the following:

• Primary Operational responsibilities include daily client interactions, facilitating internal governance calls, handling escalations, monitoring peers, providing feedback and coaching, organizing mentoring sessions, and collaborating closely with the Clients team to maintain high standards of Operational Excellence.
• Responsible for achieving all queue targets, including quality, productivity, schedule adherence, shrinkage, and attrition.
• Engage in daily client interactions concerning staffing vs forecast and work directives.
• Balance resources based on client requirements and directives.
• Manage outliers within the Queue effectively.
• Meet SLAs, shrinkage, and attrition targets.
• Address all administrative issues within the team, including attendance matters and schedule adherence.
• Oversee and ensure compliance with data protection policies to meet HIPAA standards.
• Commit to promoting equal opportunities and fairness in the workplace at all levels.
• Utilize people, process, and technical expertise to identify opportunities for quality and process design improvements that align with the company's mission of achieving Faster, Cheaper, Better outcomes while maintaining social impact.
• Initiate and cultivate partnerships with customers and customer success managers to define and assess service performance outcomes.
• Collaborate with senior stakeholders in other functions to identify and create synergies for an optimal client experience.
• Work collaboratively with delivery client teams and stakeholders across iMerit, considering the diverse needs of each stakeholder.

Skill requirements

• Profound expertise in claim adjudication, benefit and eligibility verification, and claim authorization.
• In-depth knowledge of U.S. healthcare terminology, Insurance policies, regulations, and industry trends.
• Competence in using healthcare software and electronic health records (EHR) systems.
• Exceptional written and verbal communication skills, enabling effective interaction with clients and colleagues across borders.
• Skillful in motivating employees, resolving conflicts, and making tough decisions when needed.
• Demonstrated ability to conduct data-driven analyses, including defining problems, exploring data, and communicating results effectively.
• Detail-oriented with a strong commitment to quality.
• Proficiency in managing geographically dispersed teams.
• Passionate about technology and committed to continuous learning to stay updated on the latest developments.
• A collaborative team player who can work independently and is self-motivated to deliver high-quality results promptly.
• Thrives in a fast-paced startup environment, adept at managing multiple, competing priorities simultaneously, and comfortable with ambiguity in an ever-evolving setting.

If you meet the qualifications as described above and are enthusiastic about taking the helm of a high-achieving team in a fast-paced professional setting, we cordially invite you to submit your application. Please include your resume that elucidates your pertinent professional experience and significant accomplishments.