Client Operations Manager

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Plutus Health Inc.

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2008

🏥 Saúde

⚕️ Seguro de Saúde

💳 Fintech

Healthcare • Healthcare Insurance • Fintech

A Plutus Health Inc. é uma provedora líder de soluções de gerenciamento do ciclo de receita (RCM), especializada em faturamento médico abrangente, codificação e serviços de gestão de negativas, adaptados para provedores de saúde em todo os Estados Unidos. Com mais de 15 anos de experiência, a empresa utiliza tecnologias avançadas, incluindo automação de processos robóticos (RPA) e inteligência artificial (IA), para simplificar os processos de faturamento, melhorar os percentuais de reclamações limpas, reduzir as taxas de negativas e aprimorar o desempenho financeiro geral de seus clientes em diversas especialidades médicas. A Plutus Health está comprometida em fornecer serviços de alta qualidade, em conformidade com a HIPAA, que permitem às organizações de saúde otimizar o gerenciamento de seu ciclo de receita e oferecer um melhor atendimento ao paciente.

Descrição

• Serve as the primary point of contact for assigned hospital clients • Build and maintain strong, long-term client relationships • Conduct regular client meetings to review performance metrics, address concerns, and identify opportunities for improvement • Respond promptly to client inquiries and resolve issues in a professional and timely manner • Manage the daily activities of Koders on their assigned teams • Ensure productivity and quality standards are maintained • Monitor coding productivity, accuracy, turnaround times, and service-level agreements (SLAs) • Coordinate with coding managers and quality assurance teams to ensure client expectations are consistently met • Analyze operational reports and communicate trends, risks, and opportunities to internal leadership and clients • Support staffing forecasts and workload balancing to maintain service commitments • Maintain working knowledge of ICD-10-CM, CPT, HCPCS, and medical terminology • Understand specialty-specific coding requirements and payer guidelines • Assist clients with coding-related questions and documentation improvement opportunities • Support denial management and coding-related appeals when necessary • Stay current on CMS regulations, coding updates, and compliance requirements • Ensure coding activities comply with HIPAA, CMS regulations, payer requirements, and company policies • Review quality metrics and coordinate corrective action plans when performance issues arise • Prepare and present monthly performance reports to clients and leadership • Track KPIs including coding accuracy, productivity, denial rates, turnaround times, and customer satisfaction • Identify opportunities to improve processes and enhance operational efficiency

🎯 Requisitos

• Bachelor's degree in Healthcare Administration, Business Administration, Health Information Management, or related field preferred • 4+ years of medical coding experience • 1+ years of client management, account management, operations, or healthcare services experience required • Must have experience with outsourced coding client management • Experience working with physician, hospital, and/or outpatient coding environments • Familiarity with revenue cycle management processes and denial management • One or more of the following certifications required: CPC® (Certified Professional Coder) CCS® (Certified Coding Specialist) RHIT® (Registered Health Information Technician) RHIA® (Registered Health Information Administrator) • Strong understanding of ICD-10-CM, CPT, and HCPCS coding systems • Knowledge of CMS regulations, payer policies, and HIPAA requirements • Excellent client relationship and communication skills • Strong analytical and problem-solving abilities • Proficiency with EHR systems, coding software, and Microsoft Office applications • Ability to manage multiple priorities and work in a fast-paced environment • Strong presentation and reporting skills

🏖️ Benefícios

• Ability to work remotely or in an office environment • Prolonged periods sitting and working on a computer • Occasional travel to client sites or company meetings may be required