Sr Manager-RCM

Inviting applications for the role of Senior Manager, Medical- RCM (Revenue Cycle Management!

We are seeking a dedicated and detail-oriented Medical Billing and collections Specialist with some years of experience in the US healthcare billing and collections process. This role is ideal for a professional who understands end-to-end billing functions and is passionate about accuracy, compliance, timely submission of claims, and resolution of denials, and appeals. If you%27re a strong communicator, analytical thinker, and growth-driven individual, this is the opportunity for you.

Responsibilities

• Oversee the planning, organization, direction, and implementation of all claims management processes and controls to ensure the accuracy and timeliness of claim submissions, collections efforts, and payment distribution in compliance with contractual, state, and federal regulations


• Stay updated on insurance industry regulations, policies, and coding standards, ensuring compliance and implementing necessary changes


• Ensures efficient accounts receivable management. Use routine monitoring reports, such as claim submission rates, denial rates, and reimbursement trends, to oversee the revenue cycle operational functions.


• Identify and address areas of improvement to maximize reimbursement and minimize billing errors. Collaborate with insurance companies, B2B clients, and third-party payers to address claims inquiries, appeals, and payment discrepancies.


• Monitors work queues responsible for and develops remediation plans for any backlogs that could occur operationally


• Supervise patient billing and collections staff on a daily basis, including hiring, monitoring productivity standards, and departmental training


• Formulate appropriate professional targets for each of the team members. Ensure collection goals for the department are met.


• Attend, participate, and lead at required meetings and work groups.


• Foster positive working relationships with internal and external stakeholders, promoting effective communication and collaboration


• Provide leadership. Serve as a role model and share resources.


• Actively participate in department projects and improvement initiatives


• Interface with upper management, including Director, VP, and Sr. VP in Operations,

Qualifications we seek in you!

Minimum Qualifications / Skills

.Must have B.Com or M.Com degree

Preferred Qualifications/ Skills

.Experience in US healthcare billing and collections.

.Experience in handling a team of 50+ agents /%24 500 M+ in accounts receivable

.Experience in CMS billing and Account Receivable management.

.Experience in multiple EMR/EHR work queue management within RCM

.Adaptable, open to change, and able to work in ambiguous situations and respond to new information and unexpected circumstances.

.Strong billing requirements knowledge with a detailed understanding of how to strategize accounts receivable and optimize operations

.Experience working with third-party collection agencies

.Self-motivated and strong leadership to challenge the status quo

.Strong Customer Focus and ability to get results.

.Demonstrated process improvement skills.

.Ability to make business decisions under uncertainty

.Familiar with commercial and government payers (Medicare, Medicaid, etc.)

.Experience in billing and collections associated with skill nursing, post surgical care, and home health specialties will be Preferred

.Strong communication skills - verbal and written.

.High attention to detail and analytical thinking.

.Proficient in billing platforms such as Kareo, AdvancedMD, Athena, or similar systems.

.Work Environment

oOperate within a structured framework but is you are expected to be proactive and analytically independent in your own area of responsibility

Employment Type: Full-Time

Shift: [US Shift/Night Shift EST/EDT hours]