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 competency
• Knowledge 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 PowerPoint 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 needed
• Collaborate 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 PowerPoint, 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 advantage
• Experience in multiple sites based corporate clients will be an additional advantage

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