Assistant Manager

- Responsible for planning, tracking, and coordinating payment integrity projects to ensure timely delivery of audit, coding review, and claims validation initiatives. Monitors project metrics, manage governance reporting, tracks risks and action items, supports stakeholder communication, and ensures compliance with client and payer requirements. Works closely with operations, quality, audit, MIS, and leadership teams to drive process improvements, productivity, and operational excellence. Clinical experience and skillset, to review clinical information/medical record and summarize relevant clinical information based on set of guidelines/criteria. Performs best practice reviews and identify areas for improvement

Responsibilities
Roles & Responsibilities:

- Strong personal and professional ethics.

- Strong written (documentation) and oral communication skills.

- Must have strong analytical, problem-identification and process analysis skills with the ability to envision a solution from requirements.

- Working within the timelines and getting necessary sign-off on each stage of work from stakeholders.

- Maintenance and updating reports as required.

- Must ensure availability for meeting/calls as required.

- Work independently and as a team.

- Liaison with the program/project manager as required.

- Good team player & collaborative approach.

- Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs.

- Track project milestones, deliverables, and timelines.

- Evaluate and analyze MIS reports, dashboards, and governance presentations.

- Monitor productivity, quality, and SLA performance.

- Coordinate with operations, audit, coding, and client teams.

- Manage risks, issues, and action-item closures.

- Support process improvement and compliance initiatives.

- Facilitate meetings and maintain project documentation.

- Collaborate with cross-functional teams, including Analytics, Repricing, Quality, and Compliance, to optimize coding operations and resolve coding-related issues.

- Monitor and analyze key performance indicators (KPIs), identify performance gaps, and implement continuous improvement initiatives.

- Apply payment integrity principles to identify inaccuracies, documentation deficiencies and revenue optimization opportunities.

- Ensure compliance with healthcare regulations.

- Project management and stakeholder coordination.

- Reporting and data analysis (Excel, Power BI, PPT).

- Healthcare claims/clinical coding knowledge.

- Risk tracking and governance reporting.

- Strong communication and organizational skills.

- Comprehensive understanding of CMS, Medicare, Medicaid, LCDs, NCDs, commercial payer policies, and reimbursement methodologies.

- Strong analytical and problem-solving abilities with a focus on identifying coding discrepancies and implementing process improvements.

- Effective communication and stakeholder management skills with the ability to collaborate across departments.

- Ability to manage multiple priorities, work independently, and meet deadlines in a fast-paced environment.

- Sound knowledge of healthcare regulations, including HIPAA, HITECH, and industry compliance requirements.

Desired Skills:

Qualifications
Experience:

- Good knowledge of MS-Excel, MS PowerPoint, good analytical skills, Clinical experience: Minimum 2-3 years.

Qualification:

- MBBS in India/ Bachelor’s degree in clinical or healthcare information management or a related field.

Communication Skill:

- Strong written (documentation) and oral communication skills.

Working Hours:

- 40 hours per week as Full-time employee

- Shift time: 8:00 AM IST - 5:00 PM IST (Flexible hours based on requirements)

- Weekends Off

Telecommuter/Internet requirements, if applicable:

- High Speed internet connection at home, must be broadband

- Must understand and adhere with telecommuter policy.