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Job Description & How to Apply Below
Position Overview
We are seeking an accomplished leader with extensive experience in end‑to‑end US Healthcare Revenue Cycle Management (RCM) to oversee operations, drive strategic performance improvements, manage client relationships, and build high‑performing teams. The ideal candidate is an expert in denial management, AR operations, payer processes, provider credentialing, quality governance, and transition management , with a proven track record of leading large teams across diverse revenue cycle functions.
Key Responsibilities
Operational Leadership
Lead and manage large-scale RCM teams across multiple lines of business, including AR, Denial Management, Coding Assistance, Provider Data Management, Credentialing, and Billing .
Oversee daily production, quality metrics, TAT adherence, and SLA delivery for all operational functions.
Conduct performance reviews, quality audits, huddles, scheduling, staffing, and workflow planning.
Optimize process performance through Lean methodology, RCA, POA, and continuous improvement frameworks.
Client & Stakeholder Management
Act as the primary point of contact for client interactions, operational escalations, and business reviews (monthly/quarterly).
Manage client expectations and ensure optimal service delivery in alignment with contractual SLAs and KPIs.
Communicate workflow status, dashboards, and operational updates to stakeholders across geographies.
Proactively identify issues and create action plans for timely resolution.
Quality, Compliance & Governance
Ensure adherence to internal and external compliance standards, including payer guidelines and regulatory norms.
Review process audit findings and implement corrective measures.
Support UAT, automation processes, T&M studies, and digital transformation initiatives such as RPA and AI.
People Management
Hire, mentor, train, and develop large teams, including managers, team leads, and associates.
Drive employee engagement, performance appraisals, up‑skilling, cross‑training, and retention programs.
Promote a culture of continuous improvement, innovation, and service excellence.
Strategic & Financial Management
Monitor business performance, identify cost optimization opportunities, and contribute to financial goals.
Lead transitions, stabilize new processes, and ensure successful knowledge transfer during migrations.
Support business development activities, RFP/RFQ preparation, and client solutioning.
Required Skills & Expertise
Expert‑level knowledge in US Healthcare RCM: Denials, AR, Medical Billing, Coding Support, Credentialing, Enrollment, Payer Operations, Claim Adjudication.
Strong understanding of CCI edits, utilization review, medical management, interoperability, HL7/FHIR .
Proficient in Office 365, multiple PMS/EMR systems (Advanced
MD, Kareo, ECW, Centricity, AllScripts, etc.).
Strong command of Lean Six Sigma methodologies.
Experience in leading large, diverse teams (1000+ FTEs).
Excellent documentation, communication, and leadership capabilities.
Experience
19+ years in US Healthcare RCM across provider and payer domains.
Leadership experience including roles such as AVP RCM Operations, Manager AR Operations, Service Delivery Manager, and Senior Manager Operations .
Proven success in transition management, quality excellence, and scaling operations.
Personal Attributes
Strong analytical mindset and result‑oriented approach.
Excellent stakeholder management and conflict resolution skills.
Ability to drive innovation and digital transformation across processes.
High adaptability, collaboration, and mentoring capability.
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