AR Manager/RCM Manager

Primary Responsibilities:

Oversight of designated Revenue Cycle Management AR and offshore vendor outsourced to ensure all RCM functions are worked within the established timeframes for profitability.

Create strategies to identify the root cause of Billing and Coding issues

Implement and manage efficient and effective operational policies, processes, and best practices within the revenue cycle functions.

Serve as the Subject Matter Expert (SME) in revenue cycle management, including reporting results to senior leadership, identifying performance issues, and recommending actions to drive success.

Keeps abreast of all reimbursement billing procedures of the third party, private insurance, and government regulations to ensure compliance with current processes.

Establishes annual goals and objectives for the team based on the organization's overall strategic goals.

Ensures that transactions follow the Health Insurance Portability and Accountability Act (HIPAA)

Collaborates with the payer, clearinghouses, and trading partners to maintain the EDI processes and a 100% clean claims rate.

Creates reports to monitor data accuracy and statistics to find claims that have not been submitted and resolved.

Provides clarity, root cause analysis, metrics, and reporting daily to RCM Leadership.

Provides direction to the team to develop necessary data source structures to Solve EDI incidents and resolve billing submission Issues.

Implementing a system to ensure that accurate billing information is entered into the billing system(s).

Provide daily management and support to the team to ensure they are working effectively and correctly completing assigned tasks

Planning and structuring the department workflow and staffing for teammates across Multiple clients & locations.

Ensuring billers are correctly coding diagnoses and procedures through routine audits for teammates.

Travel to Vendor places to periodically check in with their respective operations.

Additional duties and responsibilities as required and/or assigned as needed

Required Qualifications/Skills:

Bachelor's degree or equivalent combination of education and experience in lieu of degree.

10 Years of Revenue Cycle experience with at least 5 years as a manager or Senior Manager.

Strong understanding of Revenue Cycle Operations within an EMS Ambulance Transportation Billing and/or demonstrated relevant domain knowledge

Leadership Skills Ability to communicate clearly and effectively while acting as a role model to coach and train team members

Motivation / Drive This role requires a desire for continuous learning. Self-starting to take on new challenges and create innovative solutions for the team to facilitate growth and expansion of skills

In-depth knowledge of HIPAA, 837, 835, 270/271, 276/277, and other healthcare EDI standard formats

Must be technically savvy and comfortable using software, including, but not limited to MS Office, Insurance Portals, and Electronic Claims Submissions

Ability to handle difficult situations tactfully and diplomatically, solving problems

Excellent organizational skills with the ability to manage multiple tasks and priorities

Ability to handle confidential & sensitive information

Professional attitude, demeanor, and work ethic.

Effective communication skills to resolve issues within the revenue cycle, including but not limited to patients, payors, and co-workers.

Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections. Fluent & Strong written/verbal communication skills

Fluent in medical terminology with an ability to oversee training

Proficient in MS Office Suite

Preferred Qualifications:

Preferably with a working internet connection of at least 100 Mbps in working from home/office. Any time they have to come to office.

Role: Operations Manager

Industry Type: BPM / BPO

Department: Customer Success, Service & Operations

Employment Type: Full Time, Permanent

Role Category: Operations

Education- UG: Any Graduate

Key Skills

Skills highlighted with '' are preferred key skills

Revenue Cycle Management

Denial Handling, Claims, CPT, Appeals, Accounts Receivable US Healthcare, Denials, Payment Posting, Medical BillingIcd-10-CmCharge PostingRejectionAR CallingAmbualnce Transportation Billing, Denial Management, RCM Ar Billing

Job Types: Full-time, Permanent

Pay: ₹50, ₹200,000.00 per month

Benefits:

• Cell phone reimbursement
• Flexible schedule
• Health insurance
• Internet reimbursement
• Paid sick time
• Work from home

Work Location: In person

Application Deadline: 15/09/2025