Job Description

Key Responsibilities: Process: Manage team production and conduct process Quality monitoring Manage work assignment allocation review of work list Encourage engage team members for continuous improvement / process optimization / automation ideas Manage Business Intelligence through reports MIS for internal / client use Determine validity of move to client , either send back instructions to Rep or approve move to client Review coding review requests quantify preventable issues Communicate to Billing, PP or Coding as applicable Scenario findings to all staff for examples that were not valid coding review needs Work with Coding on responses that can be used in appeals when, coded correctly Review denial adjustments for validity - quantify preventable issues Communicate to applicable departments to minimize and use accounts as examples in training for more effective actions. Review high risk/aged/ excessive incomplete action account balances. Manage up review AR findings and feedback Create QA Tip for week from client, payer, and account assessment scenarios Manage Global Issues Review process / function managed for Global Issues, high risk / aged items, Payer Trends, training needs for team members. Create case studies on identified issues impacting team performance / client business and share inputs with Quality Training Teams Ensure highest levels of Organization and Healthcare related compliance requirements are adhered to Ensure adherence to maintaining all necessary process documentation as per the QM Team Management: Drive high levels of employee engagement (include Daily, weekly, monthly team connects) to enable high retention and satisfaction rates Help manage team work life balance through efforts on leave planning and rostering Communicate effectively within with team members escalate issues to the management for timely resolution Continuously manage performance through timely and effective feedback and coaching Partner with Recruiting and Training functions to help improve the quality of incoming talent Monthly One on One EMPOWER connects to be closed with all the team members Client Management: Being part of daily/weekly client update calls OR reviews. Timely response to client queries and requirements over email Partner and support the BI team in preparing important client reports for the process and releasing the same to the clients as per deadlines.