Careers At Sagility

Recovery Operations Leader - Payment Integrity

Job Code : GEN/1169

Job Description

Sagility LLC is a global leader in business process management and member/patient experience, combining technology-powered services with decades of healthcare domain expertise to drive positive outcomes. We optimize the entire member experience through service offerings such as utilization management, care management, and an aging in place product suite focused on better health outcomes. We also provide extensive Payment Integrity Services to the payer markets.


We are currently hiring a Payment Integrity Recovery Operations Leader to ensure the highest level of service for our clients by coaching and developing our customer service representatives and by managing performance so that we consistently meet and exceed client expectations.


What this person will do

  • Set up and lead the team in the payment integrity recovery operation process
  • Build the recovery process, identify gaps in process, coordinate expectations/deliverables with clients, engage with our data teams, staff appropriately, build SOPs and participate in revenue cycle discussions and projections
  • Coach and develop customer service representatives to achieve team goals that support business strategies and objectives. Responsible for monitoring employee performance using approved quality processes. Responsible for managing employee performance to include coaching, reward and recognition activities and merit/performance reviews
  • Responsible for clearly communicating client and Sagility LLC expectations on an individual and team basis. Ensure production, quality levels and results to meet and exceed client expectations
  • Provide operational expertise in achieving business goals by effectively analysing and acting on reported data
  • Develop daily and weekly action Plans to address individual performance in relationship to team performance
  • Responsible for handling escalated and non-resolved customer calls
  • Participate in cross-functional activities and communications to further Sagility? s success
  • Responsible for communicating by personal example and ongoing dialogue compliance to Sagility LLC?s policies and procedures, e.g., conducting oneself as a positive role model for all employees, particularly our CSRs.


Skills/experience needed to be successful:

  • 5 years end to end management of a payment integrity recovery operations process.
  • Business process outsourcing experience, international BPO experience a strong plus
  • Strong understanding of the stages of payment integrity and the types of technology used in payment integrity recovery
  • Ability to translate payment recovery knowledge into the building, creating and implementing of new process and strategy.
  • BA/BS in Business Management or related field preferred.
  • Knowledge of call center management systems and terminology.
  • Working knowledge of PC applications for word processing and spreadsheet.
  • Demonstrated ability to improve and/or transform team processes.
  • Demonstrated ability to understand basic data and take appropriate action.
  • Demonstrated ability to lead, motivate, and develop work teams toward improved performance.
  • Demonstrated written and verbal communication skills, focusing on professionalism, conflict resolution and positive reinforcement.
  • Knowledge of US health care (ERISA/HIPAA/State Mandates)


Sagility offers competitive benefits including:

  • Medical
  • Dental
  • Vision
  • Life Insurance
  • Short-Term and Long-Term Disability
  • Flexible Spending Account
  • Life Assistance Program
  • 401K with employer contribution
  • PTO and Sick Time
  • Tuition Reimbursement 


Sagility is proud to be equal opportunity employer.  We celebrate diversity and are committed to creating an inclusive environment for all employees.


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