Senior Manager - Operation (RCM)

Job Roles & Responsibilities:

• Design, implement, and manage a comprehensive payment reconciliation process for healthcare receivables.
• Oversee accurate and timely payment posting across multiple payers, platforms, and banking channels.
• Reconcile payments against 835 remittance files, bank statements, and internal accounting systems.
• Collaborate with RCM, finance, and IT teams to resolve discrepancies and optimize reconciliation workflows.
• Develop and maintain standard operating procedures (SOPs), audit documentation, and reconciliation reports. Ensure compliance with HIPAA, CMS regulations, and payer-specific guidelines.
• Interface with banks and financial institutions to manage ACH, EFT, lockbox, and wire transfer processes.
• Lead initiatives to automate and streamline reconciliation using tools and technologies. Provide strategic insights and reporting to leadership on reconciliation performance and trends.
• Train and mentor junior staff on reconciliation

Candidate Requirements:

• Minimum 10+ years of experience in US healthcare payment posting and reconciliation.
• Strong understanding of 835/837 files, ERA/EFT workflows, and payer-specific nuances. In-depth knowledge of US banking systems, including transaction formats and reconciliation protocols.
• Proven experience in setting up and scaling reconciliation processes from the ground up.Advanced proficiency in Excel, reconciliation tools, and RCM platforms (e.g., Epic, NextGen, eClinicalWorks).
• Excellent analytical, problem-solving, and communication skills.

Preferred Qualifications:

• CPA certification with experience in healthcare finance or revenue cycle operations.
• Experience with automation tools and RPA in reconciliation workflows.
• Familiarity with denial management, cash application, and financial reporting.
• Prior experience in a BPO, healthcare provider, or payer environment.

Kindly Note:

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