Associate Director - Revenue Cycle Management (RCM)

Eclat Health; Hyderabad; Presencial; INR 5.000.000 - 7.000.000; Jornada completa

Descripción de la vacante

Eclat Health is seeking an experienced Associate Director / Director – Revenue Cycle Management (RCM) to lead end-to-end revenue cycle operations for US healthcare clients.

The ideal candidate will have extensive US healthcare RCM experience, including billing, coding, AR, denials management, and payer relations, with strong leadership to drive revenue optimization, compliance, and operational excellence.

Formación

• 14+ years of experience in US healthcare Revenue Cycle Management.
• Bachelor's degree in Healthcare Management, Business Administration, Finance, or related field; MBA preferred.
• Minimum 5 years in senior leadership roles (Senior Manager/Director).
• Experience managing large-scale US healthcare RCM operations; familiarity with HIPAA, CMS guidelines.

Responsabilidades

• Lead end-to-end US healthcare RCM operations including billing, coding, charge entry, payment posting, AR follow-up, denials management, and collections.
• Develop and execute strategic plans to improve revenue cycle performance and financial outcomes.
• Manage large-scale RCM operations and ensure SLAs and client expectations are met.
• Establish governance, performance management, and continuous improvement initiatives.
• Drive process automation, analytics, and technology transformation in RCM.
• Mentor and develop senior managers and build a high-performance culture.
• Prepare and present operational and financial performance to senior leadership.

Conocimientos

Strategic Leadership

Operational Management

US Healthcare RCM

Billing & Coding

Denial Management

Payer Relations

Educación

Bachelor's degree in Healthcare Management

Master’s degree / MBA preferred

Herramientas

Epic

Cerner

Athenahealth

eClinicalWorks

NextGen

Descripción del empleo

Associate Director - Revenue Cycle Management (RCM)

15 to 20

Full-Time

Job Description

Associate Director - Revenue Cycle Management (RCM)

Department: Revenue Cycle Management (RCM)

Designation: Associate Director – RCM

Experience: 14+ Years

Location: [Hyderabad / Mumbai – as applicable]

Employment Type: Full-Time

Job Summary

We are seeking an experienced and strategic Associate Director / Director – Revenue Cycle Management (RCM) to lead and oversee end-to-end revenue cycle operations for US healthcare clients.

The ideal candidate will have extensive experience in US healthcare RCM, including medical billing, coding, claims management, payment posting, denial management, accounts receivable (AR), collections, and payer relations. The role requires strong leadership capabilities, operational expertise, and a proven track record of driving revenue optimization, improving operational efficiency, reducing denials, and ensuring compliance with US healthcare regulations.

The candidate will be responsible for developing and executing strategic initiatives, managing large-scale operations, driving client satisfaction, and achieving business and financial objectives.

Key Responsibilities

1. Strategic Leadership & Operational Management

• Lead and manage end-to-end US healthcare RCM operations, including billing, coding, charge entry, payment posting, AR follow-up, denial management, and collections.
• Develop and execute strategic business plans to improve revenue cycle performance, operational efficiency, and financial outcomes.
• Manage large-scale RCM operations, ensuring achievement of business goals, client expectations, and operational targets.
• Establish operational governance, performance management frameworks, and continuous improvement initiatives.

2. Revenue Cycle Optimization

• Monitor and improve key performance indicators (KPIs), including Days in AR, Net Collection Rate, First Pass Resolution Rate, Denial Rate, AR Aging, and Clean Claim Rate.
• Identify revenue leakage, process inefficiencies, and operational bottlenecks and implement corrective actions.
• Drive initiatives to improve collections, reduce outstanding AR, minimize denials, and optimize reimbursement.
• Develop strategies to improve cash flow and overall financial performance.

3. Client & Payer Relationship Management

• Build and maintain strong relationships with US healthcare clients, providers, payers, and other stakeholders.
• Manage client escalations, conduct business reviews, and ensure delivery against contractual SLAs.
• Collaborate with payer representatives to resolve reimbursement issues, claims disputes, and payment discrepancies.
• Support payer contract reviews, reimbursement analysis, and negotiation strategies.

4. Compliance & Quality Management

• Ensure compliance with applicable US healthcare regulations, including HIPAA, CMS guidelines, and payer-specific billing requirements.
• Oversee coding and billing accuracy in accordance with applicable ICD-10-CM, CPT, and HCPCS guidelines.
• Conduct regular audits, quality reviews, and compliance assessments.
• Implement corrective and preventive action plans to address quality and compliance gaps.

5. Technology & Process Transformation

• Identify and implement technology solutions, automation, and analytics tools to streamline RCM operations.
• Drive process standardization, automation, and digital transformation initiatives.
• Leverage data analytics and reporting tools to support strategic decision-making.
• Collaborate with IT and business teams to enhance RCM platforms and operational reporting capabilities.

6. People & Talent Management

• Lead, mentor, and develop senior managers, operational leaders, and large RCM teams.
• Establish performance objectives, productivity benchmarks, and developmental plans.
• Build a high-performance culture focused on accountability, operational excellence, and continuous improvement.
• Drive succession planning, leadership development, and employee engagement initiatives.

7. Business Performance & Reporting

• Prepare and present operational, financial, and strategic performance reports to senior leadership.
• Conduct regular business reviews and provide actionable insights on revenue cycle performance.
• Develop annual operating plans, budgets, and resource utilization strategies.
• Identify opportunities for business growth, operational expansion, and service delivery improvements.

Required Qualifications & Experience

• Bachelor's degree in Healthcare Management, Business Administration, Finance, or a related discipline. Master's degree / MBA is preferred.
• 14+ years of experience in US healthcare Revenue Cycle Management.
• Minimum 5 years of experience in senior leadership roles such as Senior Manager, Associate Director, Director, or equivalent.
• Strong experience managing large-scale US healthcare RCM operations.
• Medical Billing and Claims Management
• AR Management and Collections
• Denial Management and Appeals
• Payment Posting and Reconciliation
• Medical Coding and Charge Capture
• Eligibility Verification and Prior Authorization
• Payer Relations and Reimbursement Management
• Strong understanding of US healthcare reimbursement models, payer guidelines, and regulatory requirements.
• Experience managing client relationships, operational SLAs, financial performance, and business reviews.
• Demonstrated ability to drive operational transformation, automation, and process improvement initiatives.
• Strategic thinking and business acumen
• Strong leadership and people management skills
• Excellent analytical and problem-solving abilities
• Strong communication, negotiation, and stakeholder management skills
• Data-driven decision-making and performance management
• Client-centric approach and operational excellence
• Ability to manage complex business challenges and deliver measurable results

Preferred Experience

• Experience working with US healthcare providers, hospitals, physician groups, and healthcare RCM service providers.
• Exposure to multiple specialties, including Physician Billing, Hospital Billing, and Specialty Billing.
• Experience with RCM platforms such as Epic, Cerner, Athenahealth, eClinicalWorks, NextGen, or similar systems.
• Experience in managing multi-client or multi-site RCM operations.
• Exposure to automation, AI-driven RCM solutions, and advanced analytics

Success Metrics

The successful candidate will be measured on:

• Improvement in Net Collection Rate and First Pass Resolution Rate.
• Reduction in Days in AR, denial rates, and aged AR.
• Achievement of client SLAs and operational targets.
• Revenue optimization and reduction in revenue leakage.
• Improvement in productivity, quality, and operational efficiency.
• Client satisfaction, employee engagement, and business growth.