Senior Manager, Technical Operations
Current• Manage PDE and Encounter Data operations and staff including: • Reconciliation of physician claims to PDE and Encounter Data to ensure all eligible claims are included for encounter submission • Reconciliation of encounter submissions to response files to ensure any eligible encounters that were not accepted are resolved and resubmitted• Manage Claims Adjudication Oversight operations and staff.• Ensure compliance with client performance guarantees, and regulatory standards.• Meet regularly with clients to review PDE metrics, answer questions, and discuss issues.• Monitor and track performance and quality metrics.• Participate in sales presentations, demonstrations, and new client implementations as needed, to ensure smooth and timely transition of new business.• Work with State/Federal Government entities, clients, and Navitus employees to discuss and resolve operational and technical issues.• Develop viable solution(s) to assure that complete and accurate PDE and Encounter Data is reported while eliminating encounter rejects and rework