About this role
Job Description:
Key Responsibilities Operations Management
• Supervise the day-to-day activities of the Charges team to ensure productivity, accuracy, and turnaround time (TAT) goals are achieved. • Monitor charge entry, claim generation, and work queues to ensure timely claim submission. • Review operational metrics and implement action plans to improve performance. • Ensure compliance with payer guidelines, client requirements, and organizational SOPs. • Conduct regular quality audits and identify process improvement opportunities. • Prepare and present daily, weekly, and monthly operational reports. Customer Interaction & Relationship Management
• Act as the primary operational point of contact for assigned clients. • Conduct regular client meetings to review operational performance, discuss concerns, and provide updates. • Build and maintain strong customer relationships through proactive communication. • Resolve client escalations by coordinating with internal stakeholders and providing timely resolutions. • Identify opportunities to improve client satisfaction and operational efficiency. Customer Onboarding
• Lead the operational onboarding of new customers and practices. • Coordinate with Configuration, Credentialing, IT, Eligibility, Claims, AR, and other internal teams to ensure a smooth transition. • Develop and maintain onboarding plans, implementation timelines, and go-live checklists. • Validate workflows, billing guidelines, payer configurations, and documentation before production go-live. • Conduct onboarding calls, process walkthroughs, and user training sessions where required. • Ensure all onboarding milestones are completed within agreed timelines. Team Leadership
• Lead, mentor, and coach team members to achieve individual and team objectives. • Conduct regular performance reviews, feedback sessions, and skill development activities. • Assist in recruitment, onboarding, and training of new team members. • Promote a culture of accountability, collaboration, and continuous improvement. Process Improvement
• Identify operational gaps and recommend automation or process enhancements. • Collaborate with Quality, MIS, and technical teams to improve workflows. • Drive initiatives to reduce rework, improve first-pass acceptance rates, and enhance operational efficiency. • Participate in client implementation and process transformation projects. Required Qualifications
• Bachelor's degree in Healthcare Administration, Business Administration, Life Sciences, or a related field. • 5–8 years of experience in Medical Billing/Revenue Cycle Management. • Minimum 2 years of supervisory or team lead experience in a Charges or Billing function. • Experience in customer onboarding and client relationship management. • Strong understanding of charge entry, claim creation, payer requirements, and healthcare billing workflows. • Experience working with behavioral health or ambulatory care practices is preferred. Required Skills
• Strong customer communication and presentation skills. • Excellent stakeholder management and relationship-building abilities. • Project coordination and implementation experience. • Strong analytical and problem-solving skills. • Ability to manage multiple customer implementations simultaneously. • Knowledge of medical billing software, EHR/PM systems, and clearinghouses. • Advanced proficiency in Microsoft Excel, PowerPoint, and reporting tools. • Strong leadership, coaching, and conflict-resolution skills. • Ability to work in a fast-paced, deadline-driven environment. Preferred Experience
• Experience with customer onboarding and implementation projects. • Exposure to workflow documentation, SOP creation, and process mapping. • Experience working with behavioral health EHRs such as CareLogic, Credible, InSync, or similar platforms is preferred. • Knowledge of claim edits, payer-specific billing requirements, and denial prevention strategies. Key Performance Indicators (KPIs)
• Charge Entry Accuracy • Turnaround Time (TAT) • First-Pass Claim Acceptance Rate • Productivity and SLA Compliance • Client Satisfaction Score (CSAT) • Successful Onboarding and Go-Live Timelines • Quality Audit Scores • Team Engagement and Performance Metrics • Escalation Resolution Time • Process Improvement Initiatives Delivered Core Competencies
• Customer Focus • Leadership • Operational Excellence • Strategic Thinking • Communication • Accountability • Team Development • Problem Solving • Collaboration • Continuous Improvement
Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.