Job Summary
The Revenue Cycle Management (RCM) Manager is responsible for overseeing the end\-to\-end revenue cycle process, ensuring timely and accurate billing, claims submission, payment posting, denial management, accounts receivable (AR) follow\-up, and revenue optimization. The role focuses on maximizing reimbursement, improving cash flow, ensuring compliance with healthcare regulations, and leading RCM teams to achieve operational and financial goals.
Key Responsibilities:Revenue Cycle Operations
- Manage the complete revenue cycle from patient registration through final payment collection.
- Oversee medical billing, coding coordination, charge capture, claims processing, and reimbursement activities.
- Ensure timely submission of clean claims and monitor claim acceptance rates.
- Develop and implement strategies to improve collections and reduce AR aging.
Denial Management \& AR Follow\-up
- Analyze denial trends and implement corrective actions.
- Monitor and reduce denial rates through root cause analysis.
- Oversee AR follow\-up activities and ensure timely resolution of outstanding claims.
- Track and improve key performance indicators (KPIs) related to collections and reimbursements.
Team Leadership
- Lead, mentor, and develop RCM staff, team leads, and supervisors.
- Establish performance goals and conduct regular performance evaluations.
- Provide ongoing training on payer guidelines, billing regulations, and process improvements.
- Foster a culture of accountability, collaboration, and continuous improvement.
Financial Performance
- Monitor daily, weekly, and monthly revenue cycle metrics.
- Prepare operational and financial reports for senior leadership.
- Identify opportunities to increase revenue and improve operational efficiency.
- Support budgeting, forecasting, and revenue planning activities.
Compliance \& Quality Assurance
- Ensure compliance with HIPAA, CMS regulations, payer requirements, and organizational policies.
- Maintain audit readiness and support internal and external audits.
- Develop and enforce standard operating procedures (SOPs) and quality standards.
- Monitor coding and billing compliance in collaboration with coding teams.
Process Improvement
- Implement best practices and automation initiatives to enhance productivity.
- Conduct workflow analysis and recommend process improvements.
- Collaborate with cross\-functional teams including Coding, Clinical, Finance, and IT.
- Participate in system implementations, upgrades, and optimization projects.
Required Qualifications
- Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or related field.
- 5–8\+ years of experience in Revenue Cycle Management, Medical Billing, or Healthcare Operations.
- 2–5 years of leadership or people management experience.
- Strong understanding of medical billing, claims processing, denials management, and reimbursement methodologies.
- Experience with major payer regulations including Medicare, Medicaid, and commercial insurance.
- Proficiency in RCM software, practice management systems, and Microsoft Excel.
Preferred Qualifications
- Master's degree in Healthcare Administration (MHA), Business Administration (MBA), or related field.
- Professional certifications such as:
- Certified Revenue Cycle Representative (CRCR)
- Certified Professional Biller (CPB)
- Certified Professional Coder (CPC)
- Certified Healthcare Financial Professional (CHFP)
Key Skills
- Revenue Cycle Management
- Medical Billing \& Coding Knowledge
- Denial Management
- Accounts Receivable Management
- Financial Analysis \& Reporting
- Process Improvement
- Team Leadership \& Coaching
- Stakeholder Management
- Regulatory Compliance
- Data Analytics \& KPI Management
- Problem Solving \& Decision Making
- Excellent Communication Skills
Key Performance Indicators (KPIs)
- Net Collection Rate
- Days in Accounts Receivable (AR)
- Clean Claim Rate
- Denial Rate
- First\-Pass Resolution Rate
- Cash Collection Performance
- Bad Debt Percentage
- Revenue Realization Rate
- Team Productivity Metrics
- Customer/Client Satisfaction Scores
Pay: ₹20,295\.71 \- ₹73,275\.88 per month
Benefits
- Flexible schedule
- Health insurance
- Paid sick time
- Provident Fund
Work Location: In person