Operations Manager – Revenue Cycle Management (RCM)
Key Responsibilities
- Drive day-to-day operations management across the revenue cycle, ensuring stability, efficiency, and consistent achievement of collections targets.
- Execute strategies to improve claim resolution, reduce denials, and optimize AR performance using data-driven insights.
- Oversee core RCM functions, including:
- Prior Authorization
- Insurance Verification
- Denial Management
- AR Follow-up
- Patient Billing
- Manage downstream operations such as Payment Posting, AR Management, Denials Resolution, and Patient Financial Services to ensure seamless workflow and revenue optimization.
- Monitor and manage KPIs, SLAs, and productivity metrics, taking corrective actions to address performance gaps and improve outcomes.
- Ensure compliance with payer guidelines, regulatory standards, and client-specific requirements across multiple specialties.
- Lead and manage large teams (100–120 FTEs), including Team Leads and Supervisors, in a high-performance environment.
- Provide ongoing coaching, mentoring, and performance management to develop strong leadership pipelines and engaged teams.
- Conduct performance reviews, skip-level meetings, and regular feedback sessions to drive accountability and continuous improvement.
- Prepare and present weekly and monthly operational reports, dashboards, and insights using Excel and PowerPoint for internal leadership and clients.
- Support and lead client interactions, including status calls and Monthly Business Reviews (MBRs), delivering clear performance updates and action plans.
- Implement process improvements and standard operating procedures (SOPs) to enhance productivity, quality, and turnaround time.
- Drive a culture of customer service excellence, quality assurance, and compliance adherence.
- Partner with cross-functional teams to resolve escalations, improve workflows, and ensure end-to-end process efficiency.
- Lead employee engagement, retention, and development initiatives to maintain a motivated and high-performing workforce.
Work Location: In person
