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Revenue Cycle Management Expert

2 weeks ago

Aligarh, Uttar Pradesh, India beBeeLeader Full time ₹ 10,00,000 - ₹ 15,00,000
RCM Team Lead

We are seeking an experienced professional to establish and manage a new Revenue Cycle Management (RCM) team in India. The ideal candidate will possess strong leadership skills and expertise in medical billing, coding, prior authorization, denial management, and insurance verification.

Key Responsibilities:

  • Team Setup & Leadership:
    • Recruit, train, and manage a team of 4+ experienced billers and coders.
    • Establish Standard Operating Procedures (SOPs), workflows, and performance metrics from the ground up.
  • RCM Operations Management:
    • Medical Billing & Coding
    • Prior Authorizations
    • Payer Credentialing
    • US Healthcare Insurance Verification
    • Charge Entry & Payment Posting
    • Denials Management
    • Accounts Receivable (AR) Follow-ups
    • Ensure Health Insurance Portability and Accountability Act (HIPAA) compliance and process efficiency.
  • Performance & Quality Control:
    • Monitor Key Performance Indicators (KPIs): Accounts Receivable (AR) days, First Pass Resolution Rate, and Denial %.
    • Identify and resolve bottlenecks to improve revenue cycle efficiency.
  • Client & Stakeholder Communication:
    • Liaise directly with stakeholders for process updates and escalations.
    • Provide regular reports and actionable management insights.

Requirements:

  • 10+ years of proven 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 Practice Management/Electronic Health Record (PM/EHR) systems (Athena, eCW, AdvancedMD, Kareo, Practice Fusion, and NextGen).
  • Proven ability to build and lead high-performing teams.
  • Excellent written and verbal communication skills.
  • Strong leadership presence and decision-making skills.