Operations Manager

1 week ago

India, IN R1 RCM Full time

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation and workflow orchestration.


With over 30,000 employees globally and a robust presence in India, comprising over 17,000 employees across Delhi NCR, Hyderabad, Bangalore, and Chennai, we foster an inclusive culture where every team member feels valued and empowered. Our mission is to transform the healthcare industry by driving efficiency for healthcare systems, hospitals, and physician practices, continuously striving to make healthcare work better for everyone


Designation: Operations Manager


Reports to (level of category): Senior Operations Manager


Role Objective

Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash posting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company.


Essential Duties and Responsibilities

Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures.

a) Day-to-day operations

b) People Management (Work Allocation, On job support, Feedback & Team building)

c) Performance Management (Productivity, Quality, One-On-One sessions, KRA, PIP)

d) Reports (Internal and Client performance reports)

e) Work allocation strategy

f) CMS 1500 & UB04 AR experience is mandatory.

g) Span of control - 80 to 100

h) Thorough knowledge of all AR scenarios and Denials

i) Expertise in both Federal and Commercial payor mix

j) Excellent interpersonal skills

h) Should be capable of interacting with US clients and managing escalations


Qualifications

a) Graduate in any discipline from a recognized educational institute

b) Good analytical skills and proficiency with MS Word, Excel and PowerPoint

c) Good communication Skills (both written & verbal)


Skill Set

a) Candidates should be good in Denial Management

b) Candidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials.

c) Ability to interact positively with team members, peer group and seniors.

d) Demonstrated ability to exceed performance targets.

e) Ability to effectively prioritize individual and team responsibilities.

f) Communicates well in front of groups, both large and small.

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