Associate Director- RCM

Annova Solutions; Indore District; On-site; INR 2,500,000 - 4,000,000; Full time

Job summary

Annova Solutions Corp. is seeking an experienced Revenue Cycle Management professional to play a key role in expanding our Provider RCM practice.

The candidate will independently review AR/ATB files, identify recovery opportunities and develop action-oriented strategies and operating models. As an RCM SME, you will engage in client discussions, due diligence and new business pursuits to scale the RCM service line.

Qualifications

• 8–10+ years of experience in US Healthcare Revenue Cycle Management, preferably within healthcare BPO, provider operations, consulting or RCM services.
• Strong hands-on experience in AR follow-up, denials, claims management and revenue recovery.
• Demonstrated ability to analyze large ATB/AR datasets and convert the analysis into actionable recovery strategies.

Responsibilities

• Lead and support RCM operations across areas such as Accounts Receivable, Denials Management, Claims Follow-up, Underpayments, Payment Variance, Billing and Revenue Recovery.
• Independently analyze ATB/AR inventory by aging, payer, balance, denial category, claim status, specialty, location and other relevant dimensions.
• Identify collectability, liquidation opportunities, high-value inventory, denial trends and root causes within AR portfolios.
• Develop revenue recovery models that estimate collectible dollars, recovery timelines, staffing requirements, productivity, cost-to-collect and expected ROI.
• Segment inventory and develop differentiated work strategies based on age, balance, payer, denial type, likelihood of recovery and financial impact.
• Establish operational KPIs including AR days, aging distribution, denial rates, net collection rate, cash collections, productivity, quality, liquidation rate and cost-to-collect.
• Identify opportunities for automation, analytics, workflow optimization and AI-enabled interventions across the revenue cycle.
• Serve as the RCM SME during client meetings, discussing operational challenges and proposed solutions with client leadership.
• Participate in new business pursuits, discovery sessions, RFPs, solution design, due diligence and presentations.
• Translate client data and operational challenges into a compelling business case, staffing model, transition approach and value proposition.
• Help develop Annova's RCM capabilities, including SOPs, operating models, productivity benchmarks, solution frameworks, governance structures and best practices.
• Support transition and stabilization of new RCM engagements and collaborate with Operations, Analytics, Technology and Business Development teams

Skills

AR follow-up

denials management

claims management

revenue recovery

data analysis

Excel

BI/Analytics

Tools

Excel

BI/Analytics

Job description

Annova Solutions is looking for an experienced Revenue Cycle Managementprofessional to play a key role in expanding our Provider RCM practice. This positionrequires a strong combination of RCM operations expertise, analytical capability,client-facing skills, and solution design experience.The ideal candidate should be able to independently review an ATB/AR file, understandthe composition and quality of the inventory, identify revenue recoveryopportunities, and develop actionable recovery strategies and operating models.This individual will also serve as an RCM Subject Matter Expert (SME) in clientdiscussions, solution sessions, due diligence, and new business pursuits as Annovascales its RCM service line.

Key Responsibilities:-

• Lead and support RCM operations across areas such as Accounts Receivable,Denials Management, Claims Follow-up, Underpayments, PaymentVariance, Billing and Revenue Recovery.
• Independently analyze ATB/AR inventory by aging, payer, balance, denialcategory, claim status, specialty, location and other relevant dimensions.
• Identify collectability, liquidation opportunities, high-value inventory, denialtrends and root causes within AR portfolios.
• Develop revenue recovery models that estimate collectible dollars, recoverytimelines, staffing requirements, productivity, cost-to-collect and expected ROI.
• Segment inventory and develop differentiated work strategies based on age,balance, payer, denial type, likelihood of recovery and financial impact.
• Establish operational KPIs including AR days, aging distribution, denial rates,net collection rate, cash collections, productivity, quality, liquidation rateand cost-to-collect.
• Identify opportunities for automation, analytics, workflow optimization andAI-enabled interventions across the revenue cycle.
• Serve as the RCM SME during client meetings, confidently discussingoperational challenges, performance improvement opportunities and proposedsolutions with client leadership.
• Participate in new business pursuits, discovery sessions, RFPs, solutiondesign, due diligence and presentations.
• Translate client data and operational challenges into a compelling businesscase, staffing model, transition approach and value proposition.
• Help develop Annova's RCM capabilities, including SOPs, operating models,productivity benchmarks, solution frameworks, governance structures andbest practices.
• Support transition and stabilization of new RCM engagements and work closelywith Operations, Analytics, Technology and Business Development teams

Requirements

Required Experience & Skills:-

• 8–10+ years of experience in US Healthcare Revenue Cycle Management,preferably within healthcare BPO, provider operations, consulting or RCMservices.
• Strong hands-on experience in AR follow-up, denials, claims management andrevenue recovery.
• Demonstrated ability to analyze large ATB/AR datasets and convert the analysisinto actionable recovery strategies.
• Strong understanding of payer behavior, claim lifecycle, denial categories,aging, timely filing, appeals and reimbursement processes.
• Ability to develop revenue recovery forecasts, staffing models, productivityassumptions and financial/business cases.
• Strong analytical skills with advanced proficiency in Excel; experience withBI/analytics tools is preferred.
• Strong understanding of RCM operational metrics and industry benchmarks.
• Excellent client-facing communication and presentation skills, with the abilityto operate as a credible SME with senior client stakeholders.
• Experience supporting solution, pre-sales, RFPs or new client pursuits ishighly desirable.
• Ability to move comfortably between detailed operational analysis andexecutive-level conversations.
• Experience managing teams and driving operational performance in a metricsdriven environment.