Area Manager-Claims Management-Medical Billing and Claims Processing
Listed on 2026-08-13
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Management
Operations Management, Change Management, Business Analyst, Client Relationship Management -
Business
Operations Management, Change Management, Business Analyst, Client Relationship Management
Area Manager-Claims Management-Medical Billing and Claims Processing
Trending
Job Info- Job Identification 5741
- Posting Date 11/26/2025, 08:16 AM
- Job Role Claims Management-Medical Billing and Claims Processing
- Experience (In Years) 9-12
Key Responsibilities:
- Strategic Coordination and Alignment
- Serve as the key liaison between POD Leader and Operations/Program Leaders to ensure alignment on client engagement, requirements, and escalation management.
- Align POD-level goals with program objectives and the broader business strategy.
- Partner with Program and POD Leaders for strategic planning, including forecasting performance, capacity planning, and staffing to meet revenue goals.
- Audit Life Cycle Management:
- Collaborate across functions to ensure effective service delivery throughout the audit lifecycle—from data management and selections to recovery.
- Review exceptions, analyze anomalies, and provide insights with appropriate narrative and resolution actions.
- Monitor audit KPIs, SLAs including volume, capacity, forecasting, audit completion, TATs, priority completions, and recovery & collection
- Client Engagement:
- Maintain dual accountability with Program Leaders for client-facing communications and engagement.
- Respond to adhoc client needs, compliance, and administrative requirements promptly.
- Ensure timely and appropriate client communication alongside Program Leaders.
- Analytics and Technology:
- Lead analytics initiatives in collaboration with Program Leaders for business intelligence and advanced reporting solutions.
- Drive technology initiatives to enhance operational efficiencies and work closely with Program Leaders on solutioning.
- Service Delivery Excellence & Operational Efficiency
- Conduct continuous 360-degree reviews of service delivery and identify improvement areas.
- Work with Program Leaders to uphold high standards and timely delivery of all reports to senior leadership.
- Identify revenue leakage and bottlenecks; collaborate cross-functionally to implement scalable solutions.
- Facilitate regular review meetings with Program and POD Leaders to discuss progress and insights.
Present performance metrics, revenue trends, and risk assessments to senior management.
- Digital Transformation
- Collaborate with Digital Engineering and Tech teams to evaluate and implement automation and analytics tools aligned with business objectives.
Manager - POD Operations:
Key Responsibilities
Working Hours: 40 HOURS PER WEEK, FULL TIME EMPLOYEE.
- Strategic Thinking & Alignment
- Analytical & Data-Driven Decision Making
- Client Relationship Management
- Cross-Functional Collaboration
- Problem Solving & Escalation Management
- Process Improvement & Operational Excellence
- Leadership & Team Management
Strategic Coordination: Facilitate seamless alignment and collaboration between POD and Program operations to support overall business goals.
Audit Lifecycle Oversight: Manage the end-to-end audit process, ensuring timely, accurate, and compliant execution of audits.
Service Delivery Excellence: Drive continuous improvements in service quality to enhance client satisfaction and operational performance.
Client Relationship Management: Build and maintain strong client relationships, addressing their needs and resolving issues promptly.
Support Growth Initiatives: Partner with business development teams to identify and enable growth opportunities within POD operations.
Analytics and Technology Enablement: Lead adoption of data analytics and technology tools to improve decision-making and operational efficiency.
Compliance Management: Ensure all processes comply with regulatory requirements and internal policies, addressing any gaps proactively.
Stakeholder Engagement: Act as a bridge between key stakeholders, facilitating clear communication and collaboration.
Revenue Optimization: Identify and implement strategies to maximize revenue and profitability within POD operations.
Operational Efficiency: Continuously optimize workflows and processes to reduce costs, increase productivity, and meet performance targets.
Qualifications- Bachelor’s degree in any or related field; MBA or relevant advanced degree preferred.
- Experience:
Minimum of 10 years’…
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