
Lead RCM Operations Specialist
3 hours ago
We are seeking an experienced professional to lead and manage our Revenue Cycle Management (RCM) operations in Nagpur, India.
- Develop a team of billers and coders to drive revenue growth.
- Establish Standard Operating Procedures (SOPs), workflows, and performance metrics to optimize RCM efficiency.
- Medical Billing & Coding
- Prior Authorizations
- Payer Credentialing
- US Healthcare Insurance Verification
- Charge Entry & Payment Posting
- Denials Management
- Accounts Receivable (AR) Follow-ups
- Monitor Key Performance Indicators (KPIs) such as AR days, First Pass Resolution Rate, and Denial %.
- Identify and resolve bottlenecks to improve revenue cycle efficiency.
- Liaise with US stakeholders for process updates and escalations.
- Provide regular reports and actionable management insights.
- 10+ years of experience in US RCM, with 3+ years in a billing manager/supervisor role.
- Strong expertise in medical billing, medical coding, prior authorization, denial management, and insurance verification.
- Familiarity with ICD-10, CPT/HCPCS, and major PM/EHR systems.
- Proven ability to build and lead high-performing teams.
- Excellent written and verbal communication skills.
- Strong leadership presence and decision-making skills.
- Familiarity with compliance regulations, particularly HIPAA.
- Experience with data analysis and reporting tools.
- Ability to work in a fast-paced environment with multiple priorities.
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