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Job Details

Requisition Number 17-1565
Title Manager, Operations
City Atlanta
State GA
Description

The Operations Manager manages the day to day operational activities of the production team. 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 and ensuring that service level agreements with clients are met with no default. The Operations Manager is also required to analyze data and identify trends for performance & quality improvements.

  • Effectively lead a team responsible for Healthcare claims negotiation.
  • Meets daily/monthly production and quality targets.
  • Maintains an exemplary level of accuracy in all work.
  • Handles provider complaints: Analyzing the situation, transcribing the call and creating a corrective course of action.
  • Communicates effectively and timely with upstream functional areas to resolve issues.
  • Reviews team performance based on Historical Data and Quality Scores generated by MIS and QA departments.
  • Review documentation entered by subordinates in order to maintain data quality.
  • Minimizes absenteeism and controls attrition within the team by creating the right environment for them to work in.
  • Liaison between support function and Operations to ensure smooth functioning of day-to-day activities.
  • Takes part in regular calibration calls along with colleagues, QCAs and on site managers to ensure parity and compliance on process knowledge.
  • Responsible for data management in terms of dashboards and sending reports to clients. 
  • Keeping a tab on Login Hrs, Productive Time and ensure adherence to the standards set by the client.
  • Organizes continuous feedback sessions for the team to sensitize them towards important quality parameters.
  • Audit recorded calls as per an audit plan and work with the Team for reduction of defects in the production cycle.
  • Assists and leads the team in the modification of process guidelines or other materials associated with new functionality and/or reports.
  • Acquire knowledge of medical claim processing in general for better understanding of the negotiation process.
  • Works collaboratively to achieve results.
Requirements

What we’re looking for:

  • Bachelor's Degree preferred.
  • 2 years of Healthcare management with experience in claim processing, payment negotiations or accounts receivables.
  • Management experience (Team Manager level or Higher)
  • Proficient with Microsoft Office Suite (Word, Excel, Power Point)
  • Experience in claim processing systems.
  • Effective Communicator both written and verbal.
  • Ability to work well independently and in a team environment.
  • Ability to handle multiple tasks, prioritize and meet deadlines.
  • We are an Equal Opportunity Employer.
  • Please view Equal Employment Opportunity Posters provided by OFCCP here.

  • Cotiviti is an Equal Opportunity Employer. The Company provides equal employment opportunities to all applicants for employment without regard to gender, sexual orientation or preference, gender identity or expression, race, color, religion, national origin, ethnicity, ancestry, age, marital status, pregnancy, childbirth or related medical conditions, mental or physical disability, veteran status or any other characteristic protected by federal, state or local law, ordinance or regulation.

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