Senior Operations Manager, Healthcare Billing/Denials

About the role

This role involves leading strategic initiatives and improving processes within the Business Operations team. The focus is on managing denials and optimizing claims to enhance revenue and operational efficiency for a diverse client base. You will investigate issues, design repeatable processes, and collaborate with various internal teams to refine tools and workflows.

Key facts

What you'll do

• Guide the strategy for managing denials, overseeing the claims process from submission to resolution, and implementing solutions to reduce revenue loss.
• Conduct thorough investigations into the underlying causes of claim rejections and denials, then develop and apply preventative measures to boost operational effectiveness.
• Take charge of critical operational metrics for key client accounts, such as throughput and denial rates, using data to identify improvements.
• Create and scale automated, repeatable workflows to increase operational capacity and reduce manual tasks, collaborating with product and engineering on tool requirements.
• Act as a subject matter expert for important client accounts, working with account managers and clients to resolve issues and implement operational enhancements.

Requirements

• At least 4 years of experience in healthcare operations, revenue cycle management, healthcare consulting, or similar fields.
• Strong analytical capabilities, including the ability to perform data analysis independently using Excel, with SQL experience being highly preferred.
• Proven operational leadership, demonstrated by successfully managing cross-functional projects and improving process performance at scale.
• A systems-oriented approach, capable of understanding how people, processes, and technology interact to create value.
• A strong sense of ownership, taking accountability for outcomes and maintaining high standards.
• Excellent communication skills, able to simplify complex information for both internal and external audiences.
• A proactive approach, comfortable in fast-paced environments and adaptable to changing priorities.

Nice to have

• Experience in high-growth or technology-enabled healthcare settings.

Skills & tools

• Excel
• SQL (preferred)

Practical notes

All official communications will originate from @commure.com email addresses. Employees are required to adhere to information security policies, including protecting assets and reporting security risks, with annual attestation.