Senior Revenue Cycle Operations Manager

5 days ago


Hubli Mangalore Mysore, India beBeeRevenue Full time ₹ 12,00,000 - ₹ 24,00,000

Key Responsibilities:

  • Ensure the efficient and effective functioning of revenue cycle processes within a healthcare organization.
  • Oversee various aspects of revenue cycle operations, including patient registration, charge capture, coding, billing, claims processing, denial management, and accounts receivable follow-up.
  • Optimize revenue generation, maximize collections, and minimize denials to ensure the financial health of the organization.
Revenue Cycle Oversight
  • Manage and supervise the revenue cycle operations, ensuring compliance with regulatory requirements and industry best practices.
  • Develop and implement strategies to optimize revenue generation and enhance cash flow.
  • Monitor key performance indicators (KPIs) and financial metrics to identify trends, areas for improvement, and potential revenue leakage.
  • Collaborate with cross-functional teams, such as clinical departments, finance, coding, and compliance, to streamline revenue cycle processes.
Billing and Claims Management
  • Oversee the timely and accurate submission of claims to third-party payers, including Medicare, Medicaid, commercial insurance companies, and self-pay patients.
  • Monitor claim status and work closely with the billing team to resolve any coding or billing discrepancies.
  • Analyze denial patterns, identify root causes, and implement corrective measures to minimize denials and maximize collections.
  • Stay updated with changes in healthcare regulations, payer policies, and coding guidelines to ensure compliance and accurate billing.
Accounts Receivable Management
  • Review and analyze accounts receivable aging reports to identify delinquent accounts and take appropriate actions for timely payment.
  • Implement strategies for effective accounts receivable follow-up, including phone calls, appeals, and negotiations with payers and patients.
  • Collaborate with the finance team to reconcile payments, identify posting errors, and resolve outstanding balances.
  • Provide guidance and support to the team in resolving complex billing and reimbursement issues.
Process Improvement
  • Continuously assess revenue cycle processes, identify inefficiencies, and recommend process improvements to enhance operational efficiency and revenue integrity.
  • Implement automation and technology solutions to streamline workflows and reduce manual intervention.
  • Conduct regular audits and reviews to ensure compliance with coding guidelines, billing regulations, and internal policies.
  • Develop and deliver training programs to educate staff on revenue cycle best practices, coding updates, and compliance requirements.
Qualifications:
  • Bachelor's degree in Healthcare Administration, Business Administration, or a related field (master's degree preferred).
  • Experience in revenue cycle management or healthcare finance.
  • Strong knowledge of healthcare reimbursement systems, billing regulations, and coding guidelines (e.g., CPT, ICD-10, HCPCS).
  • Proficiency in using revenue cycle management software and electronic health record (EHR) systems.
  • Familiarity with third-party payer requirements, including Medicare, Medicaid, and commercial insurance.
  • Excellent analytical and problem-solving skills with the ability to interpret financial data and identify trends.
  • Strong leadership and team management abilities.
  • Effective communication and interpersonal skills to collaborate with various stakeholders.
  • Certified Professional Biller (CPB) or Certified Revenue Cycle Specialist (CRCS) certification is a plus.
  • Ability to stay updated with changes in healthcare regulations, payer policies, and coding guidelines.


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