Director - Operations Rcm

Job Roles & Responsibilities:Develop the Operations strategy for the organization, keeping in mind the business requirements.
Execute these innovative strategies to improve and secure business delivery.Drive and lead all the RCM and collection operations functions effectively with process improvements of existing processes.Performing operational due diligence for new prospective clients.Manage onshore centers for patient collections and Insurance billing.
Experience in project transition will be a value add.Strong understanding of revenue cycle management and KPIs standards set to optimize insurance collection.Strong understanding of all downstream revenue cycle offices and experience of handling entire functions of Health care RCM - Payment posting, AR Follow-up, Denial Management & Patient Billing (Voice & Non voice).Should have experience in expanding operations and work on prospect clients, RFPs, SOP's and DOU's etc.Ensure that the portfolio/s meets client and internal company performance benchmarks.Actively develop the management capabilities and business acumen of direct reportees, and drives the development of team members, ensuring full and well- rounded team competencyKnowledge of company policies and procedures to be able to provide the right answers to inquiries from all customers (both internal and external).Excellent analytical, verbal and written - communication and presentation skills.Proficient in Excel and Power Point to create/read/analyze weekly reports, dashboards for both internal management and clients.Strong interpersonal skills to be able to effectively relate with the public, patients, organizations and employees.Staff development including training, coaching and competency assessment.
Motivate and lead a high-performance management team.Lead and oversee the accounts receivable function within the medical billing department, including billing, claims follow-up, payment posting, and collections.Develop and implement strategic initiatives to optimize accounts receivable processes, improve billing efficiency, and maximize revenue collection.Provide leadership and guidance to accounts receivable staff, including training, mentoring, and performance management.Analyze accounts receivable data and performance metrics to identify trends, patterns, and opportunities for improvement, and implement corrective actions as neededCollaborate with other departments, such as coding, billing, compliance, and revenue cycle management, to identify opportunities for process improvements and revenue optimization.Stay updated on changes to billing regulations, reimbursement policies, and industry trends, and ensure compliance with relevant updates.Utilize advanced analytics and technology solutions to streamline accounts receivable workflows, automate repetitive tasks, and improve operational efficiency.Develop and maintain relationships with payers, healthcare providers, and other stakeholders to resolve billing issues and optimize revenue collection.Prepare regular reports and presentations for senior management, highlighting accounts receivable performance, trends, and opportunities for improvement.Candidate Requirements:At least 13+ years of Health-care RCM Experience in medical billing and accounts receivable management, with progressively increasing responsibilities and demonstrated leadership experience.Demonstrated leadership capabilities, including ability to organize and manage human resources to attain goals.Willingness to work in US shifts.Expertise with MS Office tools like Power Point, Excel, etc.
Preferred Qualification – Any Graduate or above.In-depth knowledge of accounts receivable processes, including billing, claims follow-up, payment posting, and collections.Familiarity with billing software, electronic health record (EHR) systems, and advanced analytics tools.Excellent understanding of billing regulations, compliance requirements, and reimbursement methodologies, including those related to Medicare, Medicaid, and commercial payers.Strong analytical and problem-solving skills, with the ability to interpret accounts receivable data and develop strategic solutions.Effective communication and interpersonal skills, with the ability to collaborate with diverse stakeholders and build positive relationships.Demonstrated leadership abilities, with a track record of inspiring and motivating teams to achieve accounts receivable goals.Commitment to continuous learning and professional development in the field of medical billing and healthcare administration.Experience on Radiology or Oncology Projects would be an additional advantageExperience in multiple sites based corporate clients will be an additional advantageKindly Note : At Credence, we uphold the highest standards of integrity in our recruitment process.
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