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Operations Manager

1 month ago

Taguig, National Capital Region, Philippines Conifer Health Solutions Full time

Responsible for managing the follow-up functions of Managed Care and Commercial payors for all patient accounts, and for working with designated payors to ensure proper reimbursement. Manages and coordinates team efforts between Departments within the National Insurance Center (NIC).

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Ensures compliance with state and federal laws and regulations for Managed Care and other third-party payors.
  • Maintains a thorough understanding of Managed Care concepts including HMO, PPO, POS, EPO, and capitation.
  • Facilitates the identification of issues and solutions by team members related to delays in achieving payment resolution.
  • Monitors collection processes to determine cash flow improvement opportunities.
  • Manages the aging of accounts receivable by trending and analyzing the A/R, and through communication with the payors.
  • Works with A/R supervisors to identify department training needs for system education, industry updates, and changes in collection processes and protocols.
  • Works with A/R Supervisors and staff to ensure that employee productivity and quality meets standards.
  • Manages desk assignments to meet employee productivity and collection efforts across all client facilities.

KNOWLEDGE, SKILLS, ABILITIES

  • Ensures compliance with state and federal laws and regulations for Managed Care and other third-party payors.
  • Maintains a thorough understanding of Managed Care concepts including HMO, PPO, POS, EPO, and capitation.
  • Facilitates the identification of issues and solutions by team members related to delays in achieving payment resolution.
  • Monitors collection processes to determine cash flow improvement opportunities.
  • Manages the aging of accounts receivable by trending and analyzing the A/R, and through communication with the payors.
  • Works with A/R supervisors to identify department training needs for system education, industry updates, and changes in collection processes and protocols.
  • Works with A/R Supervisors and staff to ensure that employee productivity and quality meets standards.
  • Manages desk assignments to meet employee productivity and collection efforts across all client facilities.
Seniority level

Mid-Senior level

Employment type

Full-time

Job function

Management

Industries

Hospitals and Health Care

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