US healthcare Account Manager

2 days ago

Pune, Maharashtra, India SPRY PT Full time ₹ 20,00,000 - ₹ 25,00,000 per year

Job summary

The End-to-End RCM Manager is responsible for the overall strategy and daily management of all revenue cycle functions. They lead a team to ensure accurate and timely processing of claims, maximize revenue capture, and maintain compliance with US healthcare regulations. The manager monitors key performance indicators (KPIs), drives continuous process improvement, and serves as a primary point of contact for clients or other internal departments on RCM performance.

Key responsibilities

Team leadership and management:

Supervise, coach, and mentor RCM teams across multiple functions, such as medical coding, billing, and accounts receivable (AR).

Conduct regular performance reviews and provide constructive feedback to staff to ensure departmental goals are met.

Oversee the hiring, training, and development of team members.

Operational oversight:

Lead and optimize end-to-end RCM processes, including patient registration, insurance verification, charge capture, claim submission, payment posting, denial management, and patient collections.

Monitor and analyze RCM key metrics, including AR days, denial rates, clean claim rates, and net collection rates.

Ensure all RCM workflows are efficient, accurate, and compliant with industry regulations.

Denial management and process improvement:

Develop and implement effective strategies to minimize claim rejections and accelerate reimbursement.

Collaborate with coding and billing teams to identify denial patterns and implement corrective actions.

Drive process optimization initiatives and implement best practices to improve efficiency and reduce revenue leakage.

Client and stakeholder communication:

Serve as a key point of contact for clients, addressing inquiries, providing performance updates, and conducting regular business reviews.

Collaborate with clinical, compliance, and IT departments to ensure a cohesive and effective revenue cycle.

Compliance and reporting:

Ensure strict adherence to all US healthcare regulations, including HIPAA, and stay informed on changes to coding standards (e.g., ICD-10, CPT) and billing rules.

Prepare and present regular reports and dashboards on RCM performance to senior management.

Qualifications

Education: A bachelor's degree in finance, healthcare administration, or a related field is typically required, with a master's degree often preferred.

Experience:

8+ years of experience in US healthcare revenue cycle management.

Proven experience in a supervisory or managerial role within RCM.

Experience with end-to-end RCM operations, including both front-end (e.g., patient access) and back-end processes (e.g., AR, denials).

Required skills

Leadership: Exceptional leadership, mentoring, and team development skills to motivate and guide RCM professionals.

Communication: Excellent written and verbal communication skills to effectively interact with staff, clients, and other departments

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