Job Description:

MID SHIFT :: 3PM to 12AM IST

Key Responsibilities

Operations Management

• Supervise the day-to-day activities of the Charges team to ensure productivity, accuracy, and turnaround time (TAT) goals are achieved.
• Monitor charge entry, claim generation, and work queues to ensure timely claim submission.
• Review operational metrics and implement action plans to improve performance.
• Ensure compliance with payer guidelines, client requirements, and organizational SOPs.
• Conduct regular quality audits and identify process improvement opportunities.
• Prepare and present daily, weekly, and monthly operational reports.

Customer Interaction & Relationship Management

• Act as the primary operational point of contact for assigned clients.
• Conduct regular client meetings to review operational performance, discuss concerns, and provide updates.
• Build and maintain strong customer relationships through proactive communication.
• Resolve client escalations by coordinating with internal stakeholders and providing timely resolutions.
• Identify opportunities to improve client satisfaction and operational efficiency.

Customer Onboarding

• Lead the operational onboarding of new customers and practices.
• Coordinate with Configuration, Credentialing, IT, Eligibility, Claims, AR, and other internal teams to ensure a smooth transition.
• Develop and maintain onboarding plans, implementation timelines, and go-live checklists.
• Validate workflows, billing guidelines, payer configurations, and documentation before production go-live.
• Conduct onboarding calls, process walkthroughs, and user training sessions where required.
• Ensure all onboarding milestones are completed within agreed timelines.

Team Leadership

• Lead, mentor, and coach team members to achieve individual and team objectives.
• Conduct regular performance reviews, feedback sessions, and skill development activities.
• Assist in recruitment, onboarding, and training of new team members.
• Promote a culture of accountability, collaboration, and continuous improvement.

Process Improvement

• Identify operational gaps and recommend automation or process enhancements.
• Collaborate with Quality, MIS, and technical teams to improve workflows.
• Drive initiatives to reduce rework, improve first-pass acceptance rates, and enhance operational efficiency.
• Participate in client implementation and process transformation projects.

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Life Sciences, or a related field.
• 5–8 years of experience in Medical Billing/Revenue Cycle Management.
• Minimum 2 years of supervisory or team lead experience in a Charges or Billing function.
• Experience in customer onboarding and client relationship management.
• Strong understanding of charge entry, claim creation, payer requirements, and healthcare billing workflows.
• Experience working with behavioral health or ambulatory care practices is preferred.

Required Skills

• Strong customer communication and presentation skills.
• Excellent stakeholder management and relationship-building abilities.
• Project coordination and implementation experience.
• Strong analytical and problem-solving skills.
• Ability to manage multiple customer implementations simultaneously.
• Knowledge of medical billing software, EHR/PM systems, and clearinghouses.
• Advanced proficiency in Microsoft Excel, PowerPoint, and reporting tools.
• Strong leadership, coaching, and conflict-resolution skills.
• Ability to work in a fast-paced, deadline-driven environment.

Preferred Experience

• Experience with customer onboarding and implementation projects.
• Exposure to workflow documentation, SOP creation, and process mapping.
• Experience working with behavioral health EHRs such as CareLogic, Credible, InSync, or similar platforms is preferred.
• Knowledge of claim edits, payer-specific billing requirements, and denial prevention strategies.

Key Performance Indicators (KPIs)

• Charge Entry Accuracy
• Turnaround Time (TAT)
• First-Pass Claim Acceptance Rate
• Productivity and SLA Compliance
• Client Satisfaction Score (CSAT)
• Successful Onboarding and Go-Live Timelines
• Quality Audit Scores
• Team Engagement and Performance Metrics
• Escalation Resolution Time
• Process Improvement Initiatives Delivered

Core Competencies

• Customer Focus
• Leadership
• Operational Excellence
• Strategic Thinking
• Communication
• Accountability
• Team Development
• Problem Solving
• Collaboration
• Continuous Improvement

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.