MBE/WBE Certified
Credence Global Solutions

Director – RCM (2Pos.)

Operations – RCM

Job Roles 

  • Develop the Operations strategy for the organization, keeping in mind the business requirements. Execute these innovative strategies to improve and secure business delivery.  
  • Drive and lead all the RCM and collection operations functions effectively with process improvements of existing processes.  
  • Performing operational due diligence for new prospective clients.  
  • Manage onshore centers for patient collections and Insurance billing.  
  • Experience in project transition will be a value add.   
  • Strong understanding of revenue cycle management and KPIs standards set to optimize insurance collection.  
  • Strong understanding of all downstream revenue cycle offices and experience of handling entire functions of Health care RCM – Payment posting, AR Follow-up, Denial Management & Patient Billing (Voice & Non voice).  
  • Should have experience in expanding operations and work on prospect clients, RFPs, SOP’s and DOU’s etc.  
  • Ensure that the portfolio/s meets client and internal company performance benchmarks.  
  • Actively develop the management capabilities and business acumen of direct reportees, and drives the development of team members, ensuring full and well- rounded team competency  
  • Knowledge of company policies and procedures to be able to provide the right answers to inquiries from all customers (both internal and external).  
  • Excellent analytical, verbal and written – communication and presentation skills.  
  • Proficient in Excel and PowerPoint to create/read/analyze weekly reports, dashboards for both internal management and clients.  
  • Strong interpersonal skills to be able to effectively relate with the public, patients, organizations and employees.  
  • Staff development including training, coaching and competency assessment.   
  • Motivate and lead a high-performance management team.
  • Lead and oversee the accounts receivable function within the medical billing department, including billing, claims follow-up, payment posting, and collections.
  • Develop and implement strategic initiatives to optimize accounts receivable processes, improve billing efficiency, and maximize revenue collection.
  • Provide leadership and guidance to accounts receivable staff, including training, mentoring, and performance management.
  • Analyze accounts receivable data and performance metrics to identify trends, patterns, and opportunities for improvement, and implement corrective actions as needed.
  • Collaborate with other departments, such as coding, billing, compliance, and revenue cycle management, to identify opportunities for process improvements and revenue optimization.
  • Stay updated on changes to billing regulations, reimbursement policies, and industry trends, and ensure compliance with relevant updates.
  • Utilize advanced analytics and technology solutions to streamline accounts receivable workflows, automate repetitive tasks, and improve operational efficiency.
  • Develop and maintain relationships with payers, healthcare providers, and other stakeholders to resolve billing issues and optimize revenue collection.
  • Prepare regular reports and presentations for senior management, highlighting accounts receivable performance, trends, and opportunities for improvement.
  • We are seeking a highly experienced and strategic-minded Senior Professional for our Revenue Cycle Management Team.  
  • Individuals will play a critical role in leading and optimizing the RCM function, ensuring efficient billing processes, timely collection of payments, and optimization of revenue cycle performance.  
  • The ideal candidate will have a deep understanding of medical billing and accounts receivable management, exceptional leadership abilities, and a proven track record of driving results in a healthcare environment.  

Candidate Requirements

  • At least 13+ years of Health-care RCM Experience in medical billing and accounts receivable management, with progressively increasing responsibilities and demonstrated leadership experience.
  • Demonstrated leadership capabilities, including ability to organize and manage human resources to attain goals.  
  • Willingness to work in US shifts.  
  • Expertise with MS Office tools like PowerPoint, Excel, etc.  
  • Preferred Qualification – Any Graduate or above.
  • In-depth knowledge of accounts receivable processes, including billing, claims follow-up, payment posting, and collections.
  • Familiarity with billing software, electronic health record (EHR) systems, and advanced analytics tools.
  • Excellent understanding of billing regulations, compliance requirements, and reimbursement methodologies, including those related to Medicare, Medicaid, and commercial payers.
  • Strong analytical and problem-solving skills, with the ability to interpret accounts receivable data and develop strategic solutions.
  • Effective communication and interpersonal skills, with the ability to collaborate with diverse stakeholders and build positive relationships.
  • Demonstrated leadership abilities, with a track record of inspiring and motivating teams to achieve accounts receivable goals.
  • Commitment to continuous learning and professional development in the field of medical billing and healthcare administration.  
  • Experience on Radiology or Oncology Projects would be an additional advantage
  • Experience in multiple sites based corporate clients will be an additional advantage.
Job Category: Operations (RCM)
Job Type: Full Time
Job Location: Pune IN

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