8 Rcm Operations Jobs

Greetings From Prochant !!! Opening For Senior Manager / Associate Director operations RCM - TVM Key Responsibilities and Duties: As a Manager you are responsible for several areas that are key to success for the Prochant, an outsourced billing service in the U.S. healthcare industry. In this role, you are accountable to Directors and ensure production and quality targets are met as per company requirement, you main responsibilities would include overseeing and optimizing the processes related to the organization's revenue generation. This involves managing the entire revenue cycle, from patient registration and billing to claims processing and collections. Required Skills: Should have minimum 15+ years of experience in RCM process Minimum 5 years in leadership experience Should have experience in End to end RCM process Flexible to work in night shift Overall responsibility for Monitoring all process ( cash, billing, transmission, correspondence, MIS, support, Medicare audit process, AR process, EV/ PA) Responsibilities Supervising RCM team: Leading and guiding a team of RCM specialists, ensuring they adhere to best practices and achieve performance targets. Revenue Optimization: Implementing strategies to improve the revenue cycle efficiency, minimize denials, and increase revenue collection. Data Analysis: Analyzing financial data and performance metrics to identify trends, bottlenecks, and areas for improvement. Process Improvement: Identifying opportunities to streamline revenue cycle processes, reduce costs, and enhance overall operational efficiency. Staff Training: Providing ongoing training and development for RCM staff to stay updated with industry changes and best practices. Reporting: Preparing regular reports on revenue cycle performance and presenting findings to higher management. Collaboration: Working closely with other departments like finance, billing, and clinical teams to ensure seamless coordination and communication. Compliance and Audit: Ensuring adherence to relevant laws, regulations, and internal policies during the revenue cycle process. Technology Integration: Implementing and leveraging RCM software and tools to optimize workflows and enhance revenue cycle performance. Benefits: Salary & Appraisal - Best in Industry Excellent learning platform with great opportunity to build career in Medical Billing Quarterly Rewards & Recognition Program Dinner for Night Shift Upfront Leave Credit Only 5 days working (Monday to Friday) No of openings : 1 Mode Of Interview : Zoom / Teams Contact Person : Abdul Wahab Interested candidates call / whats app to 8248165076 or share your updated CV to Abdulwahab@prochant.com

Role: Operating Leader Revenue Cycle Management Location: Gurgaon Role Overview: We are seeking an experienced and results-driven Operating Leader to oversee large-scale revenue cycle management (RCM) operations, managing end-to-end service delivery, client relationships, and P&L for accounts and annual revenue management. This is a strategic role within the Healthcare vertical and will directly report to the Global Head of Healthcare Operations based in India. The Operating Leader should possess a strong track record in operational excellence, strategic client engagement, team leadership, and financial performance management in the healthcare RCM domain. Will be responsible for providing leadership and subject matter expertise in the Provider and Payer areas with Primary focus on RCM. The personnel will be responsible for driving growth and innovation within existing clients and new potential healthcare customers. The ideal applicant should bring 16+ years of experience in the US Payer and Provider area with at least 10+ years in Revenue Cycle Management. Prior Experience in BPO/Captive operations with hands on experience leading provider practice management systems will be an added advantage. Key Responsibilities: Operational Leadership Lead delivery and operational performance across assigned Provider and/or Payer accounts right from Transition to BAU. Should implement best practices and risk mitigation strategies for new and existing RCM operations Drive productivity, efficiency, and compliance across end-to-end RCM functions (coding, billing, collections, A/R, denials, etc.). Oversee multi-site or global delivery teams, ensuring high-quality service and SLAs are met. P&L Management: Own P&L responsibility for a high value business portfolio Drive revenue growth and profitability improvements through operational excellence, automation, and strategic account management. Develop and manage budgets, forecasts, and financial reporting for assigned portfolios. Own the P&L for the healthcare vertical, ensuring achievement of financial goals through data-driven decision-making and cost optimization. Strategic Initiatives and Process Improvement: Partner with senior leadership on strategic initiatives in RCM, including automation, analytics, digital transformation, and new service offerings. Lead transformation projects that drive cost reduction, enhance quality, and scale operations. Proactively work with technology and transformation teams to implement automation and reduce cost of operations Leverage advanced analytical skills to monitor performance metrics, identify trends, and implement corrective actions for sustained growth People & Performance Management Lead large, cross-functional teams, including front-line managers and operational support functions. Build differentiated RCM operating environment Foster a First Time Right team culture Mentor and develop operational leaders to ensure a strong succession pipeline. Foster a culture of accountability, continuous improvement, and employee engagement. Client Relationship Management Serve as a strategic partner to clients, understanding their business needs and proactively identifying value-add opportunities. Manage executive-level stakeholder relationships and provide regular business reviews and performance updates. Ensure high levels of client satisfaction and retention. Candidate Profile: Bachelors degree in Business, Healthcare Administration, or related field (MBA or advanced degree preferred). Minimum 16 years of experience in BPO/Captive operations focused on US Healthcare RCM. Proven expertise in managing large-scale healthcare operations across geographies. Strong financial acumen with a demonstrated ability to manage P&L and drive profitability. Deep understanding of healthcare industry trends, compliance, and best practices. Exceptional leadership, communication, and stakeholder management skills. Strategic thinker with a hands-on approach to execution and team development. Deep expertise in end-to-end Revenue Cycle Management (RCM), including patient registration, insurance verification, medical coding, charge entry, claims submission, payment posting, denial management, and AR follow-up. Preferred Skills: Exposure to global delivery models (India, Philippines, Nearshore). Knowledge of healthcare IT platforms (e.g., Epic, Cerner, Athena). Experience driving digital/automation initiatives (e.g., RPA, AI, analytics). Six Sigma or Lean certification (preferred but not required). Qualifications Bachelors Degree

Role Objective: Manage AR, Denials and Appeal follow up operations team. Essential Duties and Responsibilities: Should have the ability to manage an operations team of 100+ FTEs. Should have the ability to manage multiple provider/hospital sites. Should have the ability to coordinate and proactively communicate with domestic counterparts and leaders. Should have excellent analytical and decision-making skills. Should have strong communication, interpersonal, and presentation skills. Candidate should be self-driven, with leadership abilities and a results-oriented approach. Should be able to identify and implement strategies for process improvement. Should have experience in inter-departmental and intra-departmental coordination with multiple stakeholders. Should have a thorough understanding of AR follow-up, denials, and appeals processes. Should be able to drive KPIs to achieve business metrics. Should ensure the timely delivery of projects and reports. Should have the ability to prepare presentations for business meetings. Should ensure and drive adherence to company policies and compliance standards. Should manage the performance of supervisors and team members. Should lead initiatives for productivity and quality improvement. Should be able to control absenteeism and attrition within organization-defined goals. Skill Set: Domain knowledge on both CM1500 and UB04 claims follow up. Operations Management. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Pre-requisite: Should have overall 7+ years of experience in RCM Operations Should have analytical skills & exhibit clear thinking/reasoning Should be able to comprehend & well-articulated to present his/her thought process well Should have excellent feedback and coaching skills

Role Objective: Key Performance Indicators (KPI) What are the measurable indicators for the role? Measurable Deliverables Training Throughput - Weightage (30%) First Pass Attempt - Weightage (25%) Production & Quality - Weightage (10%) Accurate & Time Data/MIS Reporting (15%) Basic Hygiene (Schedule Adherence, Responsiveness, Self-Conduct) - Weightage (10%) Trainee feedback - Weightage (5%) Projects (content development, any cost/ time/ FTE saving projects) - Weightage (5%) TNI BQM management Essential Duties and Responsibilities: Role type: Individual Contributor Conduct new hire, refresher training on aligned process, domain, and tools Conduct process knowledge tests, analyse results and publish findings Work closely with quality and business to identify performance gaps for new hire trainees, create and execute remediation plans to improve trainee performance Achieve set targets on various training effectiveness parameters (level I, level II) Be responsible for training batch management: o Adherence to learning plan o Maintain all batch data and reporting as per the pre-set process o Manage batch logistics training invites, ID Request & Management o Take care of people issues in the batch (performance, disciplinary, schedule adherence, EWS etc.) o On time referred to HR cases alignment (absconding, NCNS, training rejects) Be an active and effective contributor in assigned projects (e.g., new work transition, any process content creation and dissemination, etc.) Continue with hands-on work processing for aligned processes for minimum 12 hours a month Participate in client calls, understand process/tools changes or upgrades, prepare required documentation for roll-out to the aligned process teams Be accountable for self-development/learning, create & complete individual development plan for self, continuously stay invested to be a subject matter expert Stay compliant with the HIPAA and other company policies/compliance Job Description: Effective giving and taking feedback, coaching, and mentoring skills Strong interpersonal skills and ability to manage varied trainee personality types Excellent verbal and written communication skills (esp. email communication) Self-motivated and self-driven with a knack for continuously upskilling self Skill Set: Qualification and technical skills required to execute the role. Candidate should be graduated and 3 years of exp in AR follow up role Technical Skills : Experience in Revenue Cycle Management for U.S. Healthcare & Expertise in AR Follow up end to end processes Understanding of Online Payer Portals Hands on in MS Office like: PowerPoint, Excel, and Word Ability to use virtual communication platforms effectively like: Teams, Zoom, WebEx Experience levels required to execute this role Minimum of 3 years experience in RCM of U.S. healthcare industry (frontend, middle, backend as per role alignment) Overall experience Maximum 5 years Behavioral skills competencies required for this role. E.g. Attention to detail Functional & Behavioral Skills Strong facilitation & presentation skills for both in-person & virtual environments Understanding of basics of content creation Pre-requisite: Should have overall 7+ years of experience in RCM Operations Should have analytical skills & exhibit clear thinking/reasoning Should be able to comprehend & well-articulated to present his/her thought process well Should have excellent feedback and coaching skills

Role Objective: Complete oversight of Operations, Training and Compliance for the aligned AR Follow up teams. Essential Duties and Responsibilities: Should have overall 7+ years of experience in RCM Operations Manage the AR inventory for aligned clients. Work towards resolution to reduce the aged AR and accelerate Collections. Driving results to achieve business metrics. Ensuring timely delivery of projects/assigned reports. Self-driven, People leader and result oriented. Engage the team create IDPs and groom them for growth opportunities. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Identify and Implement automation/performance improvement strategies. Manage and maintain shrinkage and attrition within organization defined goals. Ensuring and driving adherence of company policies along with Compliance. Inter-department and Intra-department coordination with multiple stakeholders. Skills Required : Should have ability to manage span of 100+ FTEs Day to Day AR Follow up Operations. Should have excellent Analytical & decision-making skills Should have excellent communication, personal, Interpersonal and Presentation skills Candidate should be Self-Driven with People Leader and Result Oriented skills Should be able to Identify & Implement strategies for Process Improvement Should be able to identify process trends, and proposing solutions Should have Inter-department and Intra-department coordination with multiple stakeholders Skills to improve Collections and Reduce AR Pre requisite : Should have ability to drive action plans & strategies Should have thorough understanding of AR follow up and Denials Management Should have knowledge of Capacity & Inventory management Should be able to drive results to achieve Business Metrics Ensuring timely delivery of projects/reports Ensuring and driving adherence of company policies along with Compliance Controlling Absenteeism and Attrition within Organization defined goals Initiatives for Productivity and Quality Improvement Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

Essential Duties and Responsibilities: Designing, developing, and maintaining databases Writing complex SQL queries for data retrieval and manipulation Optimizing database performance and ensuring data integrity Troubleshooting and resolving database-related issues Collaborating with cross-functional teams to gather requirements and implement solutions Certification: NA Skill Set: * Should have strong Analytical Skills and Advance Excel knowledge. * Should have Strong knowledge on VBA Programming. * Should have Strong knowledge on SQL (Advanced). * Should have Hand's-on Experience in Advanced Excel. * Should have AR Follow-up Domain Knowledge Pre-requisite: Should have overall 3+ years of experience in RCM Operations Should have analytical skills & exhibit clear thinking/reasoning Should be able to comprehend & well-articulated to present his/her thought process well Should have excellent feedback and coaching skills

Essential Duties and Responsibilities: Designing, developing, and maintaining databases Writing complex SQL queries for data retrieval and manipulation Optimizing database performance and ensuring data integrity Troubleshooting and resolving database-related issues Collaborating with cross-functional teams to gather requirements and implement solutions Certification: NA Skill Set: * Should have strong Analytical Skills and Advance Excel knowledge. * Should have Strong knowledge on VBA Programming. * Should have Strong knowledge on SQL (Advanced). * Should have Hand's-on Experience in Advanced Excel. * Should have AR Follow-up Domain Knowledge Pre-requisite: Should have overall 3+ years of experience in RCM Operations Should have analytical skills & exhibit clear thinking/reasoning Should be able to comprehend & well-articulated to present his/her thought process well Should have excellent feedback and coaching skills

Role Objective: Complete oversight of Operations, Training and Compliance for the aligned AR Follow up teams. Essential Duties and Responsibilities: Should have overall 7+ years of experience in RCM Operations Manage the AR inventory for aligned clients. Work towards resolution to reduce the aged AR and accelerate Collections. Driving results to achieve business metrics. Ensuring timely delivery of projects/assigned reports. Self-driven, People leader and result oriented. Engage the team create IDPs and groom them for growth opportunities. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Identify and Implement automation/performance improvement strategies. Manage and maintain shrinkage and attrition within organization defined goals. Ensuring and driving adherence of company policies along with Compliance. Inter-department and Intra-department coordination with multiple stakeholders. Skills Required : Should have ability to manage span of 100+ FTEs Day to Day AR Follow up Operations. Should have excellent Analytical & decision-making skills Should have excellent communication, personal, Interpersonal and Presentation skills Candidate should be Self-Driven with People Leader and Result Oriented skills Should be able to Identify & Implement strategies for Process Improvement Should be able to identify process trends, and proposing solutions Should have Inter-department and Intra-department coordination with multiple stakeholders Skills to improve Collections and Reduce AR Pre requisite : Should have ability to drive action plans & strategies Should have thorough understanding of AR follow up and Denials Management Should have knowledge of Capacity & Inventory management Should be able to drive results to achieve Business Metrics Ensuring timely delivery of projects/reports Ensuring and driving adherence of company policies along with Compliance Controlling Absenteeism and Attrition within Organization defined goals Initiatives for Productivity and Quality Improvement Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.