Healthcare Manager

4 days ago

Race Course, India sarainfotech Full time

Job Summary:We are seeking a dynamic and experienced US Healthcare Patient calling process Manager to lead and manage operations for our healthcare outsourcing processes. The ideal candidate will have deep knowledge of the US healthcare system (payer or provider side), expertise in Revenue Cycle Management (RCM), and proven leadership experience in a BPO environment.Key Responsibilities:Manage day-to-day operations of the US healthcare process (RCM, medical billing, claims processing, or payer services).Lead and supervise a team of supervisors, team leads, and associates to ensure delivery of SLAs and KPIs.Coordinate with clients and internal stakeholders to ensure effective communication and performance management.Analyze performance metrics (productivity, quality, TAT, etc.) and implement corrective measures as needed.Drive process improvements, automation opportunities, and cost-efficiency initiatives.Ensure compliance with HIPAA, client-specific guidelines, and data security standards.Conduct regular training, mentoring, and performance reviews of team members.Prepare and present weekly/monthly business reviews (WBRs/MBRs) to leadership and clients.Handle escalations and resolve operational challenges promptly.Work with workforce management (WFM) and quality teams for staffing, forecasting, and audits.Required Qualifications:Bachelor’s degree in healthcare administration, business management, or related field. Master’s preferred.7+ years of experience in US healthcare BPO industry with at least 3 years in a managerial role.Hands-on experience in RCM processes such as eligibility verification, coding, charge entry, payment posting, AR follow-up, and denial management.Strong leadership, client handling, and team management skills.Familiarity with tools like Epic, Athena, Kareo, or other EHR/PM systems.Excellent analytical, communication, and problem-solving skills.Flexibility to work in different shifts (EST/PST overlap, if required).Preferred Skills:Knowledge of payer side processes (claims adjudication, benefits verification, utilization management).Exposure to automation tools or Lean/Six Sigma methodologies.Experience managing multi-client accounts in a BPO setup.

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