Job Type

Full-time

Description

About the Role

The Manager is accountable for the day-to-day performance of a team within leads operations focused on analyzing, auditing, and recovering underpayments from No Surprises Act eligible claims. They ensure healthcare organizations capture maximum legitimate reimbursement thru eligible NSA claims and ensuring timelines and appropriateness for Open Negotiations and Independent Dispute Regulations (IDR) are met. Operating at the frontline of execution, the Manager translates operational priorities into daily action-driving productivity, quality, and throughput while reinforcing accountability, consistency, and adherence to standard processes.

Impact you will make?

• Deliver consistent team-level performance across throughput, cycle time, quality, and productivity
• Ensure work is executed with clear ownership, prioritization, and adherence to defined workflows
• Reinforce accountability and performance consistency across team members
• Identify and address performance gaps, inefficiencies, and workflow breakdowns within the team
• Support adoption of tools, processes, and standard ways of working

What you will do

Team Performance Ownership

• Own and drive team performance, ensuring achievement of key KPIs including throughput, productivity, quality, and cycle time
• Monitor daily performance and take action to address gaps, trends, or inconsistencies
• Own client relationships in collaboration with client success, provide operational perspective to client questions to drive success, advocacy surrounding targets and ability to create revenue forecasts

Workflow Execution

• Manage day-to-day workflow execution, ensuring work is properly prioritized, assigned, and progressing
• Ensure adherence to defined processes, payer guidelines, and quality standards

Coaching & Development

• Coach and develop supervisors to improve performance, productivity, and quality
• Provide ongoing feedback, conduct performance discussions, and reinforce accountability

Accountability & Execution Discipline

• Ensure all work has clear ownership and is completed within expected timeframes
• Reinforce consistency in execution, minimizing variability across team members

Issue Identification & Escalation

• Identify workflow issues, delays, or bottlenecks and escalate as needed
• Partner with leadership to support timely resolution

Change Adoption

• Support implementation of new tools, processes, and workflow changes
• Reinforce team adherence to updated systems and workflows

What you will bring

• Strong people leadership skills with experience managing team performance in a metrics-driven environment
• In-depth knowledge of the Open Negotiation (ON) and Independent Dispute Resolution (IDR) process, including arbitration at a Federal and State level.
• Proactive commitment to staying current on changes to CMS guidance, regulations, and operational requirements related to the No Surprises Act
• Strong ability to drive productivity, quality, and accountability at the team level
• Experience managing work queues, workflows, and daily operations
• Data-driven mindset with the ability to monitor KPIs and act on performance trends
• Strong problem-solving skills with the ability to identify issues and take corrective action
• Effective coaching and communication skills to drive team engagement and results
• Ability to operate in a fast-paced environment and manage shifting priorities
• Experience supporting adoption of new processes, tools, or systems

What we would like to see

• Associate's degree in Healthcare Administration, Business, Finance, or related field - or equivalent combination of education and relevant experience
• 3+ years working directly with No Surprises Act claims, including negotiations and IDR.
• 5+ years of experience in Revenue Cycle Management or related healthcare operations, with exposure to denial management or workflow-driven environments
• Direct experience collaborating on technology designs for advancements in automation
• Experience leading frontline teams in a metrics-driven, performance-focused environment
• Demonstrated ability to drive team-level performance, including productivity, quality, throughput, and adherence to cycle time expectations
• Experience managing work queues, daily workflow execution, and operational KPIs at the team level
• Familiarity with payer guidelines, denial processes, and revenue cycle workflows, with the ability to apply this knowledge to support accurate and efficient execution
• Experience identifying performance gaps and taking corrective action to improve team outcomes
• Experience supporting the adoption of new processes, tools, or workflow changes within a team environment
• Strong ability to reinforce accountability, consistency, and adherence to standard ways of working across team members

Core expectations

• Demonstrate integrity and ethics in day-to-day tasks and decision making, operate effectively in the environment and the environment of the work group, maintain a focus on self-development and seek out continuous feedback and learning opportunities
• Support Compliance Program by adhering to policies and procedures pertaining to HIPAA, GLBA, FCRA, and other laws applicable to business practices; this includes becoming familiar with Code of Ethics, attending training as required, notifying management when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations
• US remote-based colleagues are not permitted to work from a location outside of the United States, at any time, without prior, written approval.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer

The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position. This position may be required to perform other duties. If such work becomes a permanent and regular part of the job, a new description will be prepared.