1+ months

Manager, Healthcare Customer Service Support Operations

San Angelo, TX 76903
Regular Full Time
   

Responsibilities:
The Manager Healthcare Customer Service Support Operations has responsibility for managing teams and oversees daily operations that includes a combination of functions such as audit inventory aging/flow and reporting, document preparation, payment process posting, and customer service as assigned to ensure needs of the business are met for successful daily operations of healthcare audit and recovery. Demonstrates knowledge and expertise in carrying out the following scope of responsibilities:

Manage team(s)s of support staff in accordance with policies, laws, and in the best interest of the company; may manage teams through direct report supervisors.
Support implementation of new business outside the normal operating processes.
Handle escalated inquiries and customer service calls or complaints to clients.
Actively contribute to identify opportunities for increased efficiencies to processes, systems and tools used in delivering client services.
Ensures smooth workflow for successful completion of support activities with high quality.
Interfaces with other internal departments and subject matter experts as needed to resolve issues and communicate changes in requirements, systems, processes and procedures, as well as supports transition and adaptation by the team in a positive and effective manner.
Provides answers and handles escalation from team members; handles escalated questions and support requests from providers and resolves issues via phone and written correspondence
Drives research, analysis and resolution of complex questions, issues, and needs that arise.
Develops and ensure training and support to new team members as well as all team members for any new or changing workflows or requirements
Drives continuous improvement efforts and develops/delivers tools and training to increase knowledge, efficiency, and consistency of department output. 
Establishes and communicates goals and expectations to team(s).
Review team members performance on a regular basis and provides direction, coaching, and training in order to maximize the efficiency and results workflow process of the team(s); provides guidance and support to supervisors for the same. Develops and delivers corrective action as required in collaboration with HR. 
Conducts annual staff performance reviews and recommends for transfer, promotion, termination, etc. of the team members in collaboration with HR and next level management.
Resolves problems within the team and promotes collaboration and teamwork in order to ensure efficient, effective, team performance.
Conducts regular meetings and communicates effectively with the team.
Analyzes individual staff skills/capabilities, performance, attendance, compliance, work behaviors and adherence to policies; identifies individual and group issues and trends; communicates results and recommendations to the next level of management; and partners with management and HR to address accordingly.
Reviews and approves scheduled time off requests, timecards, and other direct supervisory responsibilities as assigned through the HR/Payroll systems.  Ensures team attendance is managed effectively in accordance with policies and procedures.
Follows and complies with company policies, processes and procedures.
Successfully completes, retains, applies and adheres to content in required training as assigned including, but not limited to, information security, anti-harassment and other compliance and policy/ procedure training applicable for position.
Develop and maintain policy and procedure documents as well as contribute to the development and/or improvement of workflows and procedures based upon changing requirements
Maintain a current knowledge of all Medicare rules, regulations, policies and procedures, and contract requirements; and ensures team members do the same.
Maintain HIPAA Certification; and ensures team members do the same.
Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.
Other Duties as assigned

*Note - All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times.  Violations to Performants policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.
Required Skills and Knowledge:
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Below are representative of the knowledge, skills, and abilities required.
Thorough working knowledge of CPT/HCPCs/ICD-9/ICD-10 coding
Strong verbal and written communication skills; Ability to communicate professionally with internal and external audiences.
Excellent interpersonal skills; Ability to maintain professionalism and composure in difficult interactions or conflict as well as builds credibility and trust.
Solid team and functional management skills; ability to effectively build teams, lead/direct the work of teams, and develop team capability.
Ability to handle any non-standard situations that may arise applying excellent judgment and decision- making skills; anticipates the consequences of actions and weighing multiple, sometimes conflicting, priorities.
Functional subject matter expertise with ability to manage and adapt workflows as needed to meet business needs in a dynamic growth environment. 
Strong systems skills and experience developing meaningful data analysis and reporting.
Ability to manage multiple projects simultaneously with exceptional organizational skills under pressure.
Strong process, project and program management skills.
Possess knowledge of Medicare rules and regulations
Demonstrated knowledge and skills in medical claims processing and/or billing experience required to perform job duties
Experience in some capacity of medical claim quality assurance, or past demonstrated experience in a QA function. 
Good problem-solving and analytical skills; ability to identify and resolve root-cause.
Able to maintain confidentiality of sensitive data.
Solid desktop system skills; strong use of standard Microsoft office applications including strong Excel skills; and adept in quickly adapting to use of various business systems and applications.
Proven attention to detail and excellent organization skill.
Ability to successfully perform function with minimum supervision.
Time management skills to effectively manage diverse workload while completing work within allocated time frames in a fast-paced dynamic environment. Ability to adapt to changes easily and assist others to do so.
Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.


Physical Requirements:
Job is performed in busy standard office environment with moderate noise level (or may be home-office setting subject to Company approval and Teleworker Agreement), sits at a desk during scheduled shift, uses office phone or headset provided by the Company for calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a mouse.
Reads and comprehends information in electronic (computer) or paper form (written/printed). 
Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment.
Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts.
Consistently communicates on the phone as required primarily within the department and company and may include client contacts or other third-party depending on assignment with account holders, may dial manually when need or use dialer system; headset is also provided.
Occasionally lift/carry/push/pull up to 10lbs.

 


Education and Experience:
BA/BS in healthcare or a related field, or equivalent combination of education and experience including High School diploma with some college level coursework.
Minimum 8+ years progressive customer service experience in the medical or health insurance field
Minimum 3+ years prior experience successfully supervising or managing similar functions and teams in professional capacity including managing exempt supervisory staff. 

Other Requirements
Ability to obtain and maintain client required clearances as well as pass company regular background and/or drug screening.
Must submit to and pass pre-hire background check, as well as additional checks throughout employment.
Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.
Must submit to and pass drug screen pre-employment (and throughout employment).
Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.

  
Visa sponsorship is not available.

Job Profile is subject to change at any time.

EEO Performant Financial Corporation is an Equal Opportunity Employer.
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. 

NO AGENCY SUBMISSIONS WITHOUT PERFORMANT AUTHORIZED AGENCY AGREEMENT AND APPROVED PERFORMANT JOB ORDER
   


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Posted: 2021-04-07 Expires: 2021-06-10

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Manager, Healthcare Customer Service Support Operations

Performant Financial
San Angelo, TX 76903

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