Director of Consolidation

Naphcare, Inc.•Vestavia Hills, AL

4d•Onsite

About The Position

NaphCare has an excellent opportunity for a Director of Consolidation to join our Corporate Headquarters in Birmingham, AL. NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare. This is not a remote position.

Requirements

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

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
Monitor key metrics including authorization aging, turnaround times, and completion rates
Ensure alignment between authorizations, claims received, and invoicing readiness
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
Ensure consistent execution of workflows, including shared inbox management and coverage planning
Promote a culture of accuracy, accountability, and customer service excellence
Provide leadership oversight for additional duties, special projects, and strategic initiatives