Process Head - RCM

Billedright Healthcare Solutions; Chennai District; On-site; INR 4,000,000 - 9,000,000; Full time

Job summary

Billedright Healthcare Solutions is seeking an experienced Senior Leader to direct the Enterprise department in Chennai. You will oversee multi-layer leadership, own revenue performance, and drive growth across existing accounts.

The role requires deep RCM expertise, strong governance skills, and a track record in implementing automation and AI-enabled processes while ensuring regulatory compliance. This is a senior, strategic position with cross-functional scope.

Qualifications

• Bachelor’s degree or higher; MBA/MHA preferred.
• 15+ years RCM experience with 5+ years in senior leadership.
• Experience in large multi-practice RCM operations across specialties.

Responsibilities

• Provide leadership and strategic direction for the Enterprise department.
• Define and implement long-term departmental strategies aligned with objectives.
• Oversee multi-layer leadership teams and ensure accountability across service delivery.
• Own financial outcomes including revenue, profitability, budgeting and stewardship.
• Drive growth through new client acquisitions and strategic partnerships.
• Executive sponsor for key client relationships and contract renewals.
• Lead governance: QBRs, YTD reviews, and business growth discussions.
• Monitor performance across RCM: charge posting, AR, denials, and reporting.
• Review AHT vs. FTE utilization and improve productivity.
• Establish governance frameworks for leadership decision-making.
• Own risk management and business continuity planning.
• Ensure HIPAA, ISMS, QMS, and payer regulations compliance.
• Drive automation, analytics, AI/GenAI, and BOT adoption.
• Foster leadership development and cross-functional capability building.
• Collaborate with Finance, Compliance, HR, Technology on budgets and audits.

Skills

Executive communication

Client governance

Automation/AI in RCM

Leadership

Strategic planning

Cross-functional collaboration

Payer regulations

Financial acumen

Risk & compliance

Education

Bachelor’s degree or higher

MBA or MHA preferred

HFMA certifications (CRCS/CRCR/LSSBB etc.)

Job description

Job Duties/Responsibilities

• Provide overall leadership and strategic direction for the Enterprise department.

• Define and implement long-term departmental strategies aligned with organizational objectives and growth plans.

• Oversee multi-layer leadership teams (Senior Managers, Managers, Process Leads, and Client Account Leads) and ensure accountability across service delivery.

• Own financial outcomes, including revenue performance, client profitability, cost optimization, budgeting, and financial stewardship.

• Drive business growth by identifying expansion opportunities, supporting new client acquisitions, and strengthening strategic partnerships across existing accounts.

• Serve as the executive sponsor for key client relationships, ensuring long-term partnership success, client retention, and achievement of contractual commitments.

• Lead strategic client governance, including executive escalations, Quarterly Business Reviews (QBRs), Year-to-Date (YTD) performance reviews, contract renewals, and business growth discussions.

• Monitor and drive performance across all RCM functions, including charge posting, payment posting, accounts receivable (AR), denials management, reporting, and client governance.

• Review AHT vs. FTE utilization, workforce capacity, and operational efficiency metrics, implementing optimization strategies to improve productivity and scalability.

• Establish and monitor operational governance frameworks to ensure effective decision-making, performance management, and accountability across all leadership levels.

• Own risk management and business continuity planning, ensuring proactive identification and mitigation of operational, financial, and delivery risks.

• Ensure compliance with HIPAA, ISMS, QMS, payer regulations, client requirements, and other applicable regulatory standards.

• Drive adoption of automation, analytics, AI/GenAI, and BOT solutions to enhance operational efficiency, scalability, and customer experience.

• Foster innovation, leadership development, succession planning, and organizational capability building across the department.

• Collaborate with Finance, Compliance, HR, Technology, and other cross-functional teams to support budgeting, audits, workforce planning, and digital transformation initiatives.

General Responsibilities

• Promote a culture of excellence, innovation, accountability, and client-first delivery.

• Ensure transparent communication with clients and internal leadership.

• Foster innovation, talent development, and succession planning within leadership layers.

• Represent the department in executive forums, client summits, and industry events

Requirements

Required Qualifications

• Bachelor’s degree or higher (MBA, MHA, or equivalent strongly preferred)

• 15+ years of end-to-end RCM experience with at least 5+ years in senior leadership roles

• Proven experience in managing large, multi-practice RCM operations across specialties

• Strong financial acumen including P&L ownership, budgeting, cost optimization, and AHT vs. FTE management.

• Experience in all specialty Revenue Cycle Management with strong understanding of reimbursement methodologies, payer policies, authorization requirements, denial management, and operational performance drivers. Preferred certifications: CRCS – Certified Revenue Cycle Specialist (AAHAM), CRCR – Certified Revenue Cycle Representative (HFMA), and Lean Six Sigma Black Belt (LSSBB), CSPR – Payment & Reimbursement, CSBI – Business Intelligence, CSPPM – Physician Practice Management (all HFMA), and PMP (PMI).

Required Skills

• Expertise in client governance, escalations, and executive-level communication

• Strong knowledge of automation/AI in RCM (BOTs, analytics, PMS optimization)

• Deep understanding of compliance standards (HIPAA, ISMS, QMS, payer regulations)

• Exceptional leadership, strategic planning, and organizational development skills

• Ability to influence and collaborate across executive, client, and cross-functional teams.

• Deep understanding of reimbursement trends, payer regulations, and revenue optimization strategies.

Performance Metrics

• Financial Outcomes – Achieve departmental revenue targets with margins planned levels and deliver year-on-year cost optimization 5%.

• RCM KPIs – Maintain collections 95%, AR aging <25 days, denials 6%, and clean claim rate 99% across practices.

• Operational Efficiency – Improve AHT vs. FTE utilization by 10% annually through workforce planning and process optimization.

• Client Governance – Ensure 95% client retention, 4.5/5 satisfaction scores, and on-time contract renewals.