Job Opportunities

Process Improvement Manager

Position Summary
We are seeking a highly analytical and detail-oriented Process Expert to lead the mapping, definition, and optimization of our end-to-end medical billing workflows. The ideal candidate will bridge the gap between clinical data and financial outcomes, ensuring our processes—from patient intake and coding to claims submission and denial management—are documented, scalable, and compliant.

Key Responsibilities
Process Mapping & Documentation: Create detailed "As-Is" and "To-Be" process maps for all RCM functions (Eligibility, Coding, Charge Entry, Claim Submission, AR Follow-up, and Payment Posting).
Workflow Optimization: Identify bottlenecks, manual redundancies, and friction points in the billing lifecycle to improve Clean Claim Rates (CCR) and reduce Days Sales Outstanding (DSO).
SOP Development: Draft and maintain a comprehensive library of Standard Operating Procedures (SOPs) to ensure consistency across billing teams and facilitate faster onboarding.
Gap Analysis: Conduct regular audits of current workflows against industry benchmarks and regulatory requirements (HIPAA, CMS, and Payer-specific guidelines).
Cross-Functional Collaboration: Work closely with IT to automate manual tasks and with the Quality Assurance team to integrate compliance checks into the workflow.
Performance Metrics: Define Key Performance Indicators (KPIs) for each process step and create dashboards to track process health and employee productivity.

Required Qualifications
Experience: 5+ years in Process Engineering or Operations Management, specifically within Healthcare RCM or Medical Billing.

Technical Skills: Proficiency in process mapping software (Lucidchart, Visio, or Miro) and deep familiarity with PM/EHR systems.

Methodology: Certification in Six Sigma (Green or Black Belt), Lean, or Kaizen is highly preferred.

Knowledge: Strong understanding of the claim lifecycle, including CPT/ICD-10 coding, EDI 837/835 transactions, and denial management strategies.

Education: Bachelor’s degree in Healthcare Administration, Business, or Industrial Engineering.

Core Competencies
Analytical Rigor: Ability to turn complex, messy data into clean, visual flowcharts.
Communication: Able to explain technical process changes to both frontline billers and executive leadership.
Adaptability: Comfortable working in the fast-changing landscape of payer rules and healthcare legislation.