Job Description

Roles & Responsibilities

• Lead, coach, and manage the Submission & Resubmission team to achieve departmental KPIs.
• Monitor daily submission and resubmission activities to ensure accuracy and timeliness.
• Review rejected or returned submissions, identify root causes, and implement corrective actions.
• Develop and maintain standard operating procedures (SOPs) for submission workflows.
• Ensure compliance with company policies, payer/client requirements, and applicable regulations.
• Coordinate with internal departments such as Operations, Quality, Billing, Coding, Customer Service, and IT to resolve submission-related issues.
• Analyze submission trends, rejection patterns, and team performance metrics.
• Prepare daily, weekly, and monthly operational reports for management.
• Conduct quality audits and provide feedback and training to team members.
• Drive process improvement initiatives to enhance productivity and reduce turnaround time.
• Manage workload distribution and resource planning to meet service-level agreements (SLAs).
• Support system upgrades, process automation, and implementation of new workflows.

Responsibilities

• Lead, coach, and manage the Submission & Resubmission team to achieve departmental KPIs.
• Monitor daily submission and resubmission activities to ensure accuracy and timeliness.
• Review rejected or returned submissions, identify root causes, and implement corrective actions.
• Develop and maintain standard operating procedures (SOPs) for submission workflows.
• Ensure compliance with company policies, payer/client requirements, and applicable regulations.
• Coordinate with internal departments such as Operations, Quality, Billing, Coding, Customer Service, and IT to resolve submission-related issues.
• Analyze submission trends, rejection patterns, and team performance metrics.
• Prepare daily, weekly, and monthly operational reports for management.
• Conduct quality audits and provide feedback and training to team members.
• Drive process improvement initiatives to enhance productivity and reduce turnaround time.
• Manage workload distribution and resource planning to meet service-level agreements (SLAs).
• Support system upgrades, process automation, and implementation of new workflows.

Desired Candidate Profile

• Bachelor's degree in Business Administration, Healthcare Management, Finance, or a related field.
• 3–5+ years of experience in submission, claims processing, revenue cycle, or related operations.
• At least 1–2 years of team leadership or supervisory experience.
• Experience with claims management or submission systems is preferred.

Employment Type

• Full Time

Company Industry

• MedicalHealthcareDiagnosticsMedical Devices

Department / Functional Area

• Administration
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