Director of Consolidation

Responsibilities

• Lead and develop consolidation staff, establishing clear expectations, accountability, and performance standards
• Drive strategic initiatives that improve consistency, scalability, and operational performance across NaphCare sites
• Foster a culture of continuous improvement, collaboration, and results-driven execution
• Oversee the end-to-end authorization lifecycle using system tools (OE/QC) to ensure accurate tracking, follow-up, and close-out
• Maintain key metrics including authorization aging, turnaround times, and completion rates
• Identify process gaps and implement system and workflow improvements to increase efficiency
• Establish and oversee processes to ensure claims accuracy, completeness, and compliance
• Validate alignment of UB-04 and CMS-1500 claims with authorizations and supporting documentation
• Monitor error trends and implement corrective actions to reduce rework and improve quality
• Ensure claims are properly reviewed, organized, and designated as ready for invoicing
• Analyze reports, dashboards, and audit results to drive performance and ensure benchmarks are met
• Ensure data integrity across systems and reporting to support accurate decision-making
• Oversee workload prioritization, resource allocation, and high-volume workflow management
• Lead initiatives to streamline processes, improve turnaround times, and enhance productivity
• Partner with Operations, IT, and Leadership to ensure timely claims processing and invoicing
• Communicate effectively with senior leadership on performance, risks, and operational priorities
• Resolve escalations and remove barriers impacting claims and authorization workflows
• Oversee onboarding, training, and ongoing development aligned with NaphCare processes
• Promote a culture of accuracy, accountability, and customer service excellence
• Provide leadership oversight for additional duties, special projects, and strategic initiatives

Qualifications

• 5+ years of medical claim experience, coding specialist preferred
• 3+ years of management experience
• Bachelor's Degree
• Ability to work within a variety of software systems, excel pivot table skills required