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AR Clinical Denials Director

5 days ago

Taguig, National Capital Region, Philippines ADI Group Full time


Position Summary - 

Responsible for Client operations including the execution of Clinical Denials. Also has overall responsibility for delivering on respective process metrics such as account cycle time and functions thereof, process cost and functions thereof, adherence to process standards, and process quality. This involves conducting continuous quality monitoring of work product delivered and human resource direction and management.

Responsible for leading and managing staff and subordinate leadership. The position also involves achieving and sustaining excellent productivity and accuracy.

Essential Duties and Responsibilities - 

  1. Oversees overall functions, ensuring standardization and compliance with established policies and procedures of Revenue Cycle Solutions
  2. Manages all KPIs in collaboration with the OPs leaders and aspects of change management as it relates to operational processes, driving process metrics, staffing and employee relations, etc.
  3. Collaborates with all segments of leadership responsible for process design and development, process monitoring, and policy and procedure development.
  4. Directs the development of tactical plans and operating budgets to achieve strategic Conifer goals; monitor progress toward goals throughout the year.
  5. Hires, trains, and develops assigned Managers, Supervisors, Analysts and others. Partners with Human Resources to maintain consistent policy and manages expectations with recruiting department to ensure staffing levels are met.
  6. Provides operational direction to assigned site and business function. Coordinates site related issues with Human Resources and Legal.

Knowledge and abilities - 

  • Registered PH Nurse
  • With Healthcare and clinical BPO/shared experience
  • With 5-7 years of relevant experience
  • 7 - 10 years experience directing a multi-facility healthcare business office