BPM Lead (USRN Supervisor)
- Taguig City, Metro Manila
- Permanent
- Full-time
- Maintain KPI for assigned sites and assist team with meeting deadlines, as needed
- Work with other leads and managers (Client) to resolve issues or escalations resulting from any errors
- Hold team accountable for meeting deadlines, completing monthly reconciliation, completing missing information, and effectively report delays and issues in a timely manner
- Review and analysis of periodic reports and metrics
- Will be accountable for daily/weekly performance updates to key stakeholders in weekly meetings
- Responsible for managing attrition and building retention strategies
- Providing regular performance feedback, giving frequent formal and informal coaching sessions and best practice sharing for accurate processing
- Responsible for queue management, shift staffing and roster management as applicable.
- Provide support to quality initiatives targeted towards process improvements
- Assist in hiring new team members
- Perform other duties as assigned
- Willing to go the extra mile when needed
- Should be comfortable handling remote staff and office-based staff
- Must have active USRN mainland license
- AHIMA or AAPC medical coding certification not required but an advantage
- Lean Training and Certification an advantage
- Should have overall 5+ year work experience with a minimum of 2 years in the role of Supervisor in a BPO setting with knowledge on one or all fields or medical Utilization Management and Review.
- Profound understanding and application of Milliman and Interqual guidelines
- Should have the ability to effectively handle large teams in a fast-moving business environment
- Must be comfortable creating process workflows and documenting processes
- Understanding and well versed in the application and process of Utilization Management, and/ or Appeals and Grievance
- Proficient knowledge on US Healthcare Practice, Clinical Documentation Improvement, medical terminologies, EDI, and HIPAA protocols are a must
- Excellent collaboration skills and good work ethics
- Excellent verbal and written business communication skills required
- Strong proficiency in Windows OS and Microsoft Office applications
- Self-starter who can manage multiple priorities with minimum direction
- Knowledge on different platforms used in the conduction of UM reviews