Clinical Operations Manager

Job Summary

A company is looking for a Clinical Operations Manager responsible for leading and managing clinical operations staff and ensuring compliance in healthcare claims processing.

Key Responsibilities

• Lead and develop clinical operations staff, including coding and nursing personnel
• Oversee the review and analysis of complex claims to ensure accuracy and compliance
• Monitor team performance to meet productivity, quality, and service level agreements (SLAs)

Required Qualifications

• Minimum high school diploma; Bachelor's degree in healthcare, business, or related field preferred
• Minimum 7 years' experience in a clinically related field, including complex billing procedures and coding
• Minimum 4 years' leadership experience with people management responsibilities
• Current coding certification by AHIMA or AAPC, or medical license (RN, MD) required
• Extensive knowledge of hospital billing, coding standards, and compliance regulations