Rcm Lead

Job Description

Company: Optum (UHG Group)

Payroll: J2W

Location: Noida & Hyderabad

Shift Timing: Evening Shift 6:00 PM to 3:00 AM (9-hour shift)

Employment Type: Contract (Extendable based on business need)

Experience Required

* 5+ years of experience in RCM backend operations
* Minimum **34 years of hands-on experience in AR & Denials Management* Prior training/facilitation experience preferred* Senior resources with strong domain expertise and excellent communication skills are acceptable

Domain Expertise

* End-to-end **Revenue Cycle Management (RCM)**
* **Billing & AR Denials** – Hospital & Physician billing* Strong exposure to **US Healthcare RCM backend workflows*** Experience in **Epic** is an added advantage

Tools & Applications

* Epic
* Cerner* STAR* IDX* EFR

Key Responsibilities

* Deliver classroom and virtual training for US & Puerto Rico (PR) staff
* Conduct domain assessments, facilitation rounds, and refresher trainings* Track and achieve training milestones and metrics:

* Training Throughput 95%
* First Pass Yield 90%* OJT productivity and ramp-up goals as per glide path* Share regular training reports and conduct chair-side coaching* Ensure process accuracy and compliance

Role 2: RCM Quality Analyst – Backend (E2 Level)

Experience Required

* 2+ years in a QA role within RCM or related operational functions
* Strong experience in AR, Denials, and Backend RCM processes

Domain Expertise

* RCM Front-end & Back-end processes
* AR follow-ups, appeals, and denials management* Audit experience across hospital and physician billing

Key Responsibilities

* Perform monthly QA audits and ensure compliance to quality standards
* Meet QA metrics:

* Productivity Target: 100%
* Rebuttal/Appeals Accuracy: 95%* Audit-the-Auditor / Calibration Score: 85%* Participate in calibration sessions and quality improvement initiatives

Interview Process

* 2 Rounds:

1. Domain Assessment / Facilitation Round (F2F preferred)
2. Personal Interview* Interview Mode: Face-to-Face preferred, especially for domain assessment* Interview Locations: NCR & Hyderabad

Certifications

* RCM Certification (Hospital & Physician AR) – Mandatory
* Excellent Communication Skills – Mandatory