Lead a team responsible for the work that makes home health claims ready to bill. You’ll manage day-to-day execution across orders management, pre-bill audit, and related medical records and contract therapy workflows—and partner with our R&D team to build better processes and technology.

Manage, coach, and support onshore and offshore team members and team leads. Set clear priorities, monitor workload and performance, and provide timely feedback and training.

Stay close to daily workflows, respond to questions, and resolve or escalate operational and clinical issues with the appropriate partners.

Develop and maintain SOPs, quality controls, and escalation paths that help the team work accurately and consistently.

Own orders and billing readiness

Oversee the pursuit of outstanding physician orders and plans of care, prioritizing aged items and orders that are holding claims while maintaining compliance follow-up for other orders.

Help the team verify physician information and preferred delivery methods, confirm receipt, follow up on missing signatures, and ensure returned orders are recorded accurately in HCHB.

Manage the pre-bill audit and held-claim workflow. Ensure claims are reviewed against applicable requirements and that holds are documented, assigned, followed up, and cleared only when requirements are met.

Coordinate with clinical, quality, medical records, contract therapy, billing, and other teams to resolve issues such as missing documentation, unverified visits, unsigned orders, and face-to-face or OASIS exceptions.

Oversee related documentation workflows, including timely handling of contract therapy notes and medical records requests, and escalate exceptions to the appropriate owner.

Improve the operating model

Use workflow boards and dashboards to monitor unsigned orders, held claims, aging, team productivity, and unbilled revenue; prioritize work and surface recurring bottlenecks.

Revenue Operations Manager

Responsibilities

Qualification

Required

Preferred

Benefits

Company

Adaptive Innovations

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