Sr RCM Director

RCM DirectorIndiaHybrid(Delhi/NCR)AboutSciometrix Sciometrix is aleading digital Health company looking for RCM Director. We are aleader in Telehealth healthcare Virtual care Management. Ourmission to engage patients to Deliver better outcomes. Sciometrixis known among customers peers and patients for clinical excellencepatient experiences and provider satisfaction. Since the inceptionof our patient count technological solutions have beenevolving.We empower healthcare providerswith advanced technology and human expertise revolutionizing apatients experience. Our propriety software and relatedtechnologies ensure HIPAA compliancy with cloud access. We haveestablished HIPAAcompliant Clinicus an artificial intelligence (AI)bot that monitors patients 24/7 and ensures fast response in theircare management program. Clinicas watches each patients vitals andalerts our licensed team when a patients program progress or vitalsare varying. Our team will then quickly contact the patient todiscuss the change. If needed we will schedule a physiciansappointment .What s in it foryou LeadStrategic Initiatives: Take charge of developing andexecuting RCM strategies aligned with organizational goals drivingpositive change and impact across the revenuecycle. Excel in YourExpertise: Showcase your advanced Excel skills andfinancial acumen to analyze data identify trends and implementsolutions that optimize revenue performance and reduce ARaging. Drive OperationalExcellence: Implement best practices and processimprovements to streamline AR and denial management workflowsenhancing efficiency and productivity.Make a Meaningful Impact: Play apivotal role in improving the financial health of the organizationby minimizing denials accelerating cash flow and maximizingreimbursement outcomes.Continuous Learning and Growth: Stayupdated on industry trends regulations and best practices throughprofessional development opportunities expanding your knowledge andskill set in healthcare revenue cyclemanagement. Collaborate with aDynamic Team: Work alongside talented professionalsin a collaborative environment leveraging your leadership andcommunication skills to foster a culture of innovation teamwork andexcellence. Contribute toPatient Care: Enhance the patient experience byensuring accurate and timely billing processes supporting theorganizations commitment to delivering highquality care andservicesPositionOverview: As the RCM Director specializing inAccounts Receivable (AR) and Denial Management you will beresponsible for overseeing all aspects of the revenue cycle relatedto AR and denial management processes. Leveraging your exceptionalknowledge of Excel financial lookup analytical abilities andexpertise in AR operations you will develop and implementstrategies to optimize revenue collection minimize denials andstreamline processes. This role requires a proactive approach toidentify opportunities for improvement establish efficientworkflows and ensure compliance with industryregulations.KeyResponsibilities:

• ARManagement:
• Lead the AR team inmanaging the entire AR lifecycle including claim submission paymentposting followup and resolution of outstandingbalances.
• Utilize advanced Excel skills andfinancial lookup techniques to analyze AR data identify trends anddevelop actionable insights to enhance revenueperformance.
• Implement strategies to acceleratecash flow reduce AR aging and improve collectionrates.
• Conduct regular reviews of AR reportsand metrics to track performance and identify areas forimprovement.
• DenialManagement:
• Develop and maintaina comprehensive denial management program to minimize claim denialsand maximize reimbursement.
• Investigate rootcauses of denials collaborate with relevant stakeholders to addressunderlying issues and implement correctiveactions.
• Utilize data mining and analysistechniques to identify patterns in denial trends and developproactive solutions to prevent futuredenials.
• Implement best practices and industrystandards to optimize denial appeals and resolutionprocesses.
• ProcessImprovement:
• Define and documentAR and denial management processes from ground up ensuring clarityefficiency and compliance with regulatoryrequirements.
• Identify opportunities forautomation and workflow optimization to streamline operations andenhance productivity.
• Collaborate withcrossfunctional teams including IT finance and clinical departmentsto implement process improvements and drive organizationalefficiency.
• TeamLeadership:
• Provide leadershipguidance and mentorship to the AR and denial management teamfostering a culture of accountability collaboration and continuouslearning.
• Set performance goals conduct regularperformance evaluations and provide constructive feedback tosupport professional development andgrowth.
• Foster a positive work environment thatpromotes teamwork innovation and excellence in AR and denialmanagement.

5.Revenue Cycle Management (RCM)Oversight:

• Manage theRCM process for clients including auditing both internal andexternal medical billing procedures.
• Identifyand resolve billing issues with insurance companies ensuring timelyresolution to prevent revenue loss.
• Implementprocesses to flag overbilling or underbilling instances maintainingaccuracy and compliance.

6.Coordination with Patients Providers and InsuranceCompanies:

• Act as aliaison between patients healthcare providers and insurancecompanies addressing billing benefits and insurancerelatedinquiries or issues.
• Ensure smoothcommunication and resolution of disputes optimizing revenuecollection and customersatisfaction.

.7.Billing and CollectionCoordination:

• Coordinatebilling and collection activities to ensure timely and accurateinvoicing and payment collection.
• Monitoraccounts receivable activity identify outstanding balances andimplement strategies to minimizedelinquency.
• Financial CloseOversight: .

8.Insurance BillingManagement:

• Ensureaccurate billing of insurance providers and patients adhering tobilling guidelines and regulations.
• Documentmedical billing denials from insurance providers analyze rootcauses and implement correctiveactions.
• Analytic &Technical Ability and DataMining
• Proficient in identifyingprocess automation opportunities and screening themeffectively.
• Skilled in coordinating andcommunicating with developers to articulate technical features andrequirements actively participating in demos and proof ofconcepts.
• Capable of analyzing large andintricate datasets discerning patterns and trends to facilitateinformed decisionmaking.
• Experienced introubleshooting issues and adept at communicating effectivelyacross relevantteams..

*Qualifications:

• Bachelorsdegree in Healthcare Administration Business Finance or relatedfield; Masters degree preferred.
• Minimum of 10years of experience in revenue cycle management with a focus on ARand denial management in a healthcaresetting.
• Strong proficiency in Microsoft Excelincluding advanced functions such as VLOOKUP pivot tables and dataanalysis.
• Proven track record of success inoptimizing AR performance reducing denials and improving revenueoutcomes.
• Indepth understanding of healthcarebilling and reimbursement processes including knowledge of payerguidelines and regulations.
• Excellentanalytical problemsolving and decisionmaking skills with theability to translate data into actionableinsights.
• Strong leadership and team managementskills with the ability to inspire and motivate teams to achievegoals and objectives.
• Exceptional communicationand interpersonal skills with the ability to collaborateeffectively with internal and externalstakeholders.

Benefits ComprehensiveInsurance benefitsFlexible workhoursAnnual PerformanceBonusReimbursements

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