Senior Manager (Hospital Billing) - RCM

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 analyse revenue cycle metrics to identify areas of improvement and implement process improvements to optimise revenue cycle performance.
• Work with internal and external stakeholders, including healthcare providers, insurance companies, and patients, to resolve billing and payment-related issues.
• Stay up to date with changes in healthcare regulations, industry standards, and technology to ensure the organisation's revenue cycle processes remain efficient and effective.
• 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.
• Perform end-to-end business diagnostic analysis to dissect to identify potential risks, gaps, and areas of improvement.
• Have a strong hold on managing internal & or external stakeholders to meet the business objectives/goals.
• Looking after capacity planning, staffing forecast and administration of the operations floor.

Qualifications:

• Degree in any related field.12+ years of experience in Revenue Cycle Management in the US healthcare industry

Key skills:

• 12+ years experience overseeing the end-to-end Revenue Cycle Management (US Healthcare).

• Good experience in Hospital Billing Mandatory.

• Should have strong domain knowledge with the ability to handle a team size of up to 50+ people across multiple functions like Eligibility Verification, Prior Authorisation, 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 organisation.
• Proficient in MS Office applications, especially in MS Excel.
• Should have exposure to the complete medical billing cycle understanding each process.
• Should be a team player and collaborate in solving any issues that might arise in day-to-day transactions.

Should have a very good knowledge & Control on Production/Quality & Attrition Management