Area Manager-Claims Management-Medical Billing and Claims Processing
EXL (ExlService Holdings, Inc.) · exlservice.com
ChennaiHybridLead / Manager
The job in short
Medical billing and claims area manager.
AuditCompliance
Details
- Found
- 25 d ago · posted 2025-11-26
- Location as listed
- Chennai, Tamil Nadu, India
- Role
- Medical Coding / Billing / Records
- Source
- The company’s own careers site
Full description
Key Responsibilities:
• Strategic Coordination and Alignment
• Serve as the key liaison between POD Leader and Operations/Program Leaders to ensure alignment on client engagement, requirements, and escalation management.
• Align POD-level goals with program objectives and the broader business strategy.
• Partner with Program and POD Leaders for strategic planning, including forecasting performance, capacity planning, and staffing to meet revenue goals.
• Audit Life Cycle Management:
• Collaborate across functions to ensure effective service delivery throughout the audit lifecycle—from data management and selections to recovery.
• Review exceptions, analyze anomalies, and provide insights with appropriate narrative and resolution actions.
• Monitor audit KPIs, SLAs including volume, capacity, forecasting, audit completion, TATs, priority completions, and recovery & collection
• Client Engagement:
• Maintain dual accountability with Program Leaders for client-facing communications and engagement.
• Respond to adhoc client needs, compliance, and administrative requirements promptly.
• Ensure timely and appropriate client communication alongside Program Leaders.
• Analytics and Technology:
• Lead analytics initiatives in collaboration with Program Leaders for business intelligence and advanced reporting solutions.
• Drive technology initiatives to enhance operational efficiencies and work closely with Program Leaders on solutioning.
• Service Delivery Excellence & Operational Efficiency
• Conduct continuous 360-degree reviews of service delivery and identify improvement areas.
• Work with Program Leaders to uphold high standards and timely delivery of all reports to senior leadership.
• Identify revenue leakage and bottlenecks; collaborate cross-functionally to implement scalable solutions.
• Facilitate regular review meetings with Program and POD Leaders to discuss progress and insights.
• Present performance metrics, revenue trends, and risk assessments to senior management.
• Digital Transformation
• Collaborate with Digital Engineering and Tech teams to evaluate and implement automation and analytics tools aligned with business objectives.
Manager - POD Operations: Key Responsibilities
Working Hours: 40 HOURS PER WEEK, FULL TIME EMPLOYEE.
Key Competencies:
• Strategic Thinking & Alignment
• Analytical & Data-Driven Decision Making
• Client Relationship Management
• Cross-Functional Collaboration
• Problem Solving & Escalation Management
• Process Improvement & Operational Excellence
• Leadership & Team Management
Strategic Coordination: Facilitate seamless alignment and collaboration between POD and Program operations to support overall business goals.
Audit Lifecycle Oversight: Manage the end-to-end audit process, ensuring timely, accurate, and compliant execution of audits.
Service Delivery Excellence: Drive continuous improvements in service quality to enhance client satisfaction and operational performance.
Client Relationship Management: Build and maintain strong client relationships, addressing their needs and resolving issues promptly.
Support Growth Initiatives: Partner with business development teams to identify and enable growth opportunities within POD operations.
Analytics and Technology Enablement: Lead adoption of data analytics and technology tools to improve decision-making and operational efficiency.
Compliance Management: Ensure all processes comply with regulatory requirements and internal policies, addressing any gaps proactively.
Stakeholder Engagement: Act as a bridge between key stakeholders, facilitating clear communication and collaboration.
Revenue Optimization: Identify and implement strategies to maximize revenue and profitability within POD operations.
Operational Efficiency: Continuously optimize workflows and processes to reduce costs, increase productivity, and meet performance targets.
• Bachelor’s degree in any or related field; MBA or relevant advanced degree preferred.
• Experience: Minimum of 10 years’ experience in US Healthcare and Payment Services LOB preferred.
• 5+ years of experience in operations management, preferably in audit lifecycle or service delivery domains.
• Proven experience in strategic planning, client engagement, and cross-functional team leadership.
• Strong analytical skills with proficiency in metrics tracking, reporting, and business intelligence tools.
• Excellent communication skills with client-facing experience.
• Ability to manage multiple stakeholders and complex escalations effectively.
• Experience with compliance standards (HIPAA, CMS) and quality assurance.
• Familiarity with digital transformation initiatives and technology-driven process improvements.
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