IKS Health
Location
Mumbai | India
Job description
Key Responsibilities:
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 QMS
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
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.
Job tags
Salary
