Operations Manager

Job Description

Job Description Oversee the entire revenue cycle process, including patient registration, insurance eligibility & Benefits verification, charge capture, coding, billing, and payment collection/posting (Must have good hands-on Basic Claims Adjudication, AR & Denial Management/Appeals Process). Manage a team of accounts receivable and billing professionals, including hiring, training, and performance evaluations. Ensure that all coding and billing practices are compliant with government regulations and industry standards, including HIPAA and CMS guidelines. Monitor and analyze revenue cycle metrics to identify areas of improvement and implement process improvements to optimize revenue cycle performance. Work with internal and external stakeholders, including healthcare providers, insurance companies, and patients, to resolve billing and payment-related issues. Work with team on the identified roadblocks / potential problems for processes/procedures and implement possible solutions to avoid any delivery impact. Collaborate with clinical staff, billing staff, and other stakeholders to improve the revenue cycle management process. Monitor key performance indicators and adjust processes as needed to meet goals. Conduct regular training and education sessions to keep staff up to date on changes in regulations and best practices. Key Skills Essential 10+ years experience overseeing the end-to-end Revenue Cycle Management (US Healthcare). Should have strong domain knowledge with ability to handle a team size of up to 50 people across multiple functions like Eligibility Verification, Prior Authorization, AR, Denial Management, Billing and preferably payment posting. Excellent written and verbal communication skills, with demonstrated ability to communicate effectively with executive leadership and all levels of the organization. Proficient in MS Office applications, especially in MS Excel. Should have exposure in complete medical billing cycle understanding each process. Should be a team player and collaborate in solving any issues that might possibly arise in day-to-day transactions. Should have a very good knowledge & Control on Production/Quality & Attrition Management