Sr. Manager

The Revenue Cycle Management (RCM) division plays a critical role in managing the financial lifecycle of patient services, encompassing everything from patient registration and insurance verification to charge capture, medical coding, claim submission, payment posting, denial management, accounts receivable follow-up, and final reimbursement. The division’s main objective is to ensure accurate billing, maximize reimbursements, reduce denials, improve cash flow, maintain regulatory compliance, and enhance operational efficiency. Working closely with healthcare providers, payers, patients, and internal teams, the division strives to optimize revenue performance while upholding high standards of service and compliance.

The Medical Billing Manager will oversee and direct all billing and revenue cycle functions to guarantee accurate claim submissions, timely reimbursements, and adherence to payer and regulatory requirements. This role includes managing billing staff, optimizing workflows, resolving complex billing issues, and driving continuous improvements to support the organization’s financial stability and operational efficiency. The manager will lead offshore delivery operations across multiple critical areas including patient access and eligibility verification, prior authorization, medical coding, charge entry, claims submission, payment posting, accounts receivable follow-up, denial management and appeals, credentialing support, patient collections, customer service, and revenue integrity and reporting. The role demands ensuring operational excellence across multiple client accounts, processes, and delivery teams.

Key Responsibilities

Client Relationship Management
- Manage end-to-end client engagement for assigned healthcare RCM accounts.
- Build trusted advisor relationships with client leadership, including CEOs, CFOs, Practice Administrators, Revenue Cycle Directors, and Billing Managers.
- Conduct regular business reviews, operational governance meetings, and strategic performance discussions.
- Drive high client satisfaction, retention, and account stability.
- Serve as the primary escalation point for operational and relationship issues.
- Ensure proactive communication and effective stakeholder management.

Operations & Delivery Oversight
- Collaborate with delivery leaders to meet SLA and KPI targets across AR follow-up, denials management, charge entry, payment posting, eligibility and authorization, coding support, and patient collections.
- Monitor key operational performance metrics such as collections, net collection rate, days in AR, aging over 90 days, denial rates, productivity, and quality.
- Lead operational improvement initiatives and process optimization efforts.
- Ensure compliance with HIPAA, payer guidelines, and client-specific standard operating procedures.

Revenue Growth & Strategic Account Management
- Identify opportunities for account expansion and cross-selling of additional RCM services.
- Support business development and transition teams during new client onboarding.
- Develop account growth strategies aligned with client objectives.
- Drive margin improvement and operational efficiency initiatives.
- Assist in contract renewals and commercial discussions.

Governance & Reporting
- Prepare executive dashboards, quarterly business review presentations, and operational reports.
- Lead weekly and monthly governance reviews with internal and external stakeholders.
- Ensure timely closure of action items, risk mitigation plans, and escalation management.
- Analyze account trends and provide actionable insights to clients.

Leadership & Team Management
- Lead cross-functional operational and client services teams.
- Mentor Assistant Managers and Team Leads.
- Foster a high-performance, accountability-driven culture.
- Collaborate with HR, Training, Quality, and Transition teams for workforce planning and capability development.

Required Qualifications
- 10 to 15+ years of experience in US Healthcare RCM or BPM operations.
- At least 5 years in client operations or account management leadership roles.
- Proven experience managing mid-to-large US healthcare provider accounts.
- Strong expertise in payer rules, denials management, and regulatory compliance including HIPAA and coding guidelines.

No preferred qualifications or benefits were specified for this role.