24 Aug
|
Datamatics
|
Puducherry
24 Aug
Datamatics
Puducherry
Role & responsibilities
Operational Management
- Lead and manage end-to-end Payment Posting operations
- Oversee Payor Mapping activities to ensure accurate configuration and alignment of payor codes, plan codes, and remittance files with client/payor systems.
- Drive daily, weekly, and monthly production, quality, and turnaround time (TAT) targets across the team.
- Ensure accurate and timely posting of insurance and patient payments, adjustments, and denials.
- Manage end-to-end Payment Posting operations across insurance and patient payments.
- Ensure timely processing of ERA, EOB, EFT, patient payments, and electronic remittances.
- Establish effective controls for unapplied cash, unidentified payments, overpayments, refunds, and payment discrepancies
Denial & Correspondence Management
- Provide guidance on denial codes, reason codes (CARC/RARC), and remark codes to ensure correct identification, categorization, and routing of denials.
- Oversee correspondence capturing processes to ensure timely and accurate documentation of payor communications, EOB notes, and denial trends.
Team Leadership
- Manage a team of 100+ associates, including Team Leads, Assistant Managers/Supervisors, Quality Analysts, and Payment Posting Executives.
- Build a strong second line of leadership through mentoring, coaching, and structured performance management.
- Drive employee engagement, retention, and career development initiatives within the team.
- Conduct regular one-on-ones, team huddles, and performance reviews.
Quality & Compliance
- Ensure adherence to HIPAA and other applicable US healthcare compliance and data security standards.
- Monitor quality metrics (accuracy, productivity, TAT) and implement corrective action plans for gaps.
- Partner with the Quality/Training team to design refresher training programs based on error trends.
Process Improvement & Reporting
- Identify process gaps and drive automation/process improvement initiatives to enhance posting accuracy and reduce manual touchpoints.
- Prepare and present daily/weekly/monthly performance dashboards and reports to senior leadership and clients.
- Participate in client calls to discuss performance, escalations, and process changes.
Stakeholder Management
- Act as the single point of contact for payment posting and payor mapping escalations; ensure resolution within defined SLA/TAT with root-cause analysis shared back to the client.
- Maintain proactive, transparent communication with internal leadership and client stakeholders to strengthen account retention, satisfaction (CSAT), and expansion opportunities.
- Lead periodic (weekly/monthly) client calls and business reviews, presenting performance dashboards, trend analysis, and improvement plans; ensure zero surprises on critical metrics.
Preferred candidate profile
- Strong hands-on knowledge of Payment Posting processes (manual and electronic/ERA posting).
- Sound understanding of Payor Mapping, payor/plan code configuration, and remittance file handling.
- In-depth knowledge of denials and denial codes (CARC/RARC), including common denial reasons in the US healthcare space.
- Working knowledge of correspondence capturing and documentation standards.
- Strong understanding of ERA and EOB interpretation and reconciliation.
- Familiarity with US healthcare billing cycle, payor types (Medicare, Medicaid, Commercial, Workers' Comp), and claim adjudication process.
- Strong people management skills with demonstrated experience managing teams of 100+.
- Excellent analytical, problem-solving, and decision-making abilities.
- Robust communication and stakeholder management skills, including experience interfacing with US-based clients.
- Proficiency in MS Excel and reporting tools; exposure to dashboards/BI tools is a plus.
📌 Walk-in || Datamatics Puducherry || Manager RCM _ Payment Posting Payor Mapping
🏢 Datamatics
📍 Puducherry