Director of Operations - PrimeCLAIMS

Do you have post-acute medical billing & claims experience? Do you understand what a claims clearinghouse does? Are you interested in bringing your experience to a product that offers our customers white glove service? If so, read on.

ProClaim Partners, LLC, is looking for an Operations Director for our primeCLAIMS team. Designed by billers for billers, our comprehensive claims system streamlines and accelerates the entire billing process. With powerful EHR integration, primeCLAIMS automates workflows to maximize efficiency and speed. Built specifically for skilled nursing facilities, primeCLAIMS ensures you capture every dollar - every day.

This position is based in Duluth, GA, and may be 100% remote for the correct candidate. Your skill, experience and talent is more important than where you live.

POSITION SUMMARY: This position is responsible for providing effective operational direction to primeCLAIMS including but not limited to client service-related functions, including Enrollment, Client Services, Payer and Intermediary Relations, Implementation and Product Development. This position directly contributes to key business outcomes such as client retention, client satisfaction, enhancing primeCLAIMS and product line value to our clients and prospects, achieving operating/margin targets and fostering a culture of performance and continuous improvement.

ESSENTIAL DUTIES AND RESPONSIBILITIES
TECHNICAL

• Establishes operations initiatives for improvement in customer support quality, problem resolution, customer retention, cost delivery, and employee relations.
• Ensures the payer network is healthy
• Monitors claims transmission statistics to ensure high reliability and accuracy
• Directs implementation and execution of customer support policies and practices throughout the organization.
• Recommends and communicates product direction and feature needs from customers
• Recommends and implements strategic changes in customer support operations strategy.
• Builds, develops and manages operations leadership team capable of carrying out needed operations strategies and improving employee relations.
• Oversee operations budget to ensure compliance with organizational expenditure requirements.
• Develops and implements procedures pertinent to the effective and efficient operation of the Customer Service Department.
• Monitors programs and procedures to ensure on-time delivery and customer satisfaction. Maintains in-depth working knowledge of primeCLAIMS.
• Sets performance standards to meet service goals of the company. Coaches staff in order to achieve high performance.
• Reviews and evaluates performance to ensure optimum customer satisfaction.
• Provides feedback to the Company regarding service failures or customer concerns. Provides feedback to product management and other team members to ensure all customers have accurate and timely information on order status and/or changes.
• Works continually towards self-development to stay current on customer service, and supervisory procedures and practices.
• Responds to customer inquiries through an escalation process and solves problems in a professional and effective fashion.
• Acts as a resource in resolving customer issues by utilizing Company process knowledge and skills in negotiating and selling.
• Motivates managers and other staff by providing timely feedback to questions/concerns, providing direction for resolving customer issues and praising them for their efforts and accomplishments.
• Review operational efficiencies on a regular basis with managers and recommend improvements to the process.
• Performs other related duties as assigned.
• SUPERVISORY
• Provide leadership, coaching, motivation, evaluation and assistance to team members across multiple environments to ensure teamwork and high performance in the accomplishment of all projects and responsibilities
• Coordinates training for new and less experienced employees
• Participates in candidate recruiting and selection
• Attends management training and meetings as assigned
• Measure employee productivity and performance and make employment recommendations
• MINIMUM QUALIFICATIONS (EDUCATION, EXPERIENCE, SKILLS AND ABILITIES)
• Bachelor's degree in management, information systems, or another related field, MBA preferred.
• Medical Claims Processing Clearinghouse & Industry Specific Knowledge of claims, billing and collections concepts and payment transaction processes IS A MUST
• Requires 8 to 10 years in customer support environment with six to ten years in customer support management.
• Possesses the highest level of software application knowledge.
• Understanding of Software development concepts, product roadmap and sprint planning.
• Demonstrates the ability to apply workflow concepts to software product to deliver useful product to customers
• Requires 5 to 7 years of experience in product implementation and/or account management.
• Must be able to read, analyze and interpret moderate to complex business correspondence.
• A demonstrated ability to lead people and obtain results through others.
• Planning: an ability to think ahead and plan over a 3-9-month time span.

Pay: $96,000.00 - $120,000.00 per year

Benefits:

• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Work Location: Hybrid remote in Duluth, GA 30097