Operations Manager/ US Healthcare/Revenue Cycle Management

3 days ago


Pune, Maharashtra, India Suma Soft Full time ₹ 12,00,000 - ₹ 36,00,000 per year

Key Responsibilities:

  1. End-to-End RCM Oversight:

  2. Manage the complete revenue cycle process including patient registration, charge capture, coding, billing, AR follow-up, payment posting, and denial management.

  3. Ensure all RCM operations comply with payer policies, HIPAA, and company standards.

  4. Team Management:

  5. Lead, train, and mentor a team of billing executives, AR callers, and analysts.

  6. Allocate workload, monitor team performance, and ensure productivity and quality benchmarks are met.

  7. Process Improvement:

  8. Identify process gaps, implement best practices, and drive automation or efficiency improvements.

  9. Analyze trends in denials, rejections, and delays to minimize revenue leakage.

  10. Reporting & Analytics:

  11. Generate daily/weekly/monthly RCM performance dashboards.

  12. Track key metrics such as DSO (Days Sales Outstanding), collection rate, denial rate, and first-pass resolution rate.

  13. Client & Stakeholder Management:

  14. Act as the primary point of contact for clients or internal stakeholders regarding billing and AR updates.

  15. Manage client escalations and ensure timely resolution of issues.

  16. Compliance & Audit:

  17. Maintain compliance with payer and regulatory guidelines.

  18. Conduct internal audits to ensure data accuracy and documentation completeness.

  19. Strategic Planning:

  20. Collaborate with senior management to set revenue targets and operational goals.

  21. Support new client transitions and process migrations.

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