Manager - Revenue Cycle Management - Healthcare Operations

Position Overview:

The RCM (Revenue Cycle Management) US healthcare operations role is a critical role in the healthcare industry. This role is responsible for overseeing the entire revenue cycle process from patient registration to payment collection. The successful candidate will be responsible for ensuring that the healthcare organization's billing and coding processes are accurate and efficient, resulting in timely payment from insurance companies and patients.

Responsibilities:

- Oversee the entire revenue cycle process, including patient registration, insurance eligibility & Benefits verification, charge capture, coding, billing, and payment collection/posting (Must have good hands on Basic Claims Adjudication, AR & Denial Management/Appeals Process).

- Manage a team of billing and coding professionals, including hiring, training, and performance evaluations.

- Good in People management.

- Ensure that all coding and billing practices are compliant with government regulations and industry standards, including HIPAA and CMS guidelines.

- Monitor and analyze revenue cycle metrics to identify areas of improvement and implement process improvements to optimize revenue cycle performance.

- Work with internal and external stakeholders, including healthcare providers, insurance companies, and patients, to resolve billing and payment-related issues.

- Stay up-to-date with changes in healthcare regulations, industry standards, and technology to ensure the organization's revenue cycle processes remain efficient and effective.

- Have a strong hold on Manage internal & or external stakeholders to meet the business objectives/goals.

- Should have a very good knowledge & Control on Production/Quality & Attrition Management.

- Work with team on the identified roadblocks / potential problems for processes/procedures and implement possible solutions to avoid any delivery impact.

- Responsible for P&L and meet monthly/quarterly/yearly GC and GM

- Qualifications: Dgree in any related field.10+ years of experience in Revenue Cycle Management in the US healthcare industry.

- Should be from a Provider Front RCM Line of Business. Payer front will be considered as a value added.

- Experience managing a team of Billing Team/AR and/or coding professionals.