Auctus Group

Revenue Operations

• Responsible for managing the strategy, documentation, procedural compliance, and financial performance of out-of-network claims that may qualify for open negotiation and Independent Dispute Resolution (IDR).
• Oversees the full lifecycle of eligible disputes, including claim and document review, eligibility assessment, deadline tracking, open negotiation, IDR initiation, offer development, preparation of supporting arguments and evidence, determination review, and payment reconciliation.
• Serves as the primary strategic partner for assigned clients and collaborates closely with several departments.
• Develops and manages monthly IDR and out-of-network dispute strategy for each assigned client.
• Reviews claims, correspondence, payment records, remittance information, contracts, and clinical documentation to determine potential dispute eligibility.
• Prepares clear, accurate, organized, and persuasive IDR submissions while maintaining complete, accurate, confidential, and audit-ready documentation for every dispute.

IDR Revenue Cycle Manager – Paralegal/Lawyer

Operations

• Implement the right processes and practices across the organization as assigned by Operations Manager
• Analyze all current operational processes and performance, recommend and implement solutions for improvement
• Ensure proper understanding and execution of all The Auctus Group policies and procedures
• Improve operational management systems, processes and best practices as needed
• Create materials, forecast, and build standard operating procedures for all operation systems
• Formulate strategic and operational objectives
• Perform quality controls and monitor KPIs per department
• Actively communicate, inspire, and motivate all levels of staff

IDR Revenue Cycle Manager – Paralegal/Lawyer

Operations Coordinator