Project Manager-Operations

HAMLY BUSINESS SOLUTIONS INDIA PRIVATE LIMITED; Tamil Nadu; On-site; INR 2,600,000 - 4,200,000; Full time

Job summary

HAMLY BUSINESS SOLUTIONS INDIA PRIVATE LIMITED seeks experienced Project Managers to lead AR and Denial Management for US Healthcare clients. You will oversee client meetings, performance reviews, and operational excellence while guiding AR teams through denials reduction and process improvements.

The role requires 8+ years in US Healthcare RCM, strong leadership, and night-shift flexibility. Prior experience with billing systems and payer portals is essential for success.

Qualifications

• 8+ years of US Healthcare Revenue Cycle Management experience.
• Minimum 3 years leading AR and Denial Management teams.
• Proven track record with client relations and executive reviews.
• Strong knowledge of AR ageing, denials, appeals, and collections.
• Experience with performance management, quality audits, and SOPs.

Responsibilities

• Lead client meetings, performance reviews, and business reviews.
• Monitor AR ageing, collections, cash acceleration and denial overturn rates.
• Identify root causes of denials and implement corrective actions.
• Manage high-balance accounts, payer escalations, and filing issues.
• Mentor AR Team Leads, Senior Denial Specialists, and Billing staff.
• Track productivity, resolution, appeal success, and quality metrics.
• Advise on workflow improvements for patient access and insurance verification.
• Ensure CMS, Medicare Part B, Medicaid, and payer policies compliance.
• Conduct quality audits, deliver refresher training, and develop SOPs.

Skills

AR ageing

denial management

client management

team leadership

communication

analytical

problem solving

Education

Graduate degree in Commerce/Healthcare Admin/Business Admin

MBA (preferred)

Tools

Healthcare billing systems

Practice management software

Clearinghouses

Payer portals

Job description

Preferred Locations

Bangalore and North India (Equal Priority); Chennai (Lower Priority)

Job Description

We are looking for experienced Project Managers to lead AR and Denial Management operations for US Healthcare clients. The ideal candidates should have strong client management, operational expertise, team leadership, and a proven track record of improving collections, reducing denials, and maintaining service quality.

Key Responsibilities

• Lead client meetings, operational performance reviews, and executive-level business reviews.
• Monitor AR ageing, collections, cash acceleration, and denial overturn rates to achieve client targets.
• Identify denial root causes and implement corrective actions to reduce repeat denials and revenue leakage.
• Manage high-balance accounts, payer escalations, timely filing issues, and clearinghouse EDI failures.
• Lead and mentor AR Team Leads, Senior Denial Specialists, and Billing Associates.
• Track team productivity, resolution rates, appeal success rates, and quality performance metrics.
• Advise clients on workflow improvements related to patient access, prior authorisation, and insurance verification.
• Ensure compliance with CMS guidelines, Medicare Part B, Medicaid regulations, commercial payer policies, and LCD/NCD guidelines.
• Conduct quality audits, deliver refresher training, and develop SOPs for denial management, payer escalations, and billing processes.
• Plan resource capacity and shift coverage while ensuring operational performance and client satisfaction.

Candidate Requirements

• 8+ years of experience in US Healthcare Revenue Cycle Management (RCM).
• Minimum 3 years of team-handling experience in AR and Denial Management.
• Proven experience independently managing client relationships and executive-level business reviews.
• Strong knowledge of AR ageing, denial management, appeals, payer escalation, and collections.
• Experience in performance management, quality audits, process improvement, and SOP development.
• Hands-on experience with healthcare billing systems, practice management software, clearinghouses, and payer portals.
• Excellent communication, analytical, problem-solving, and leadership skills.
• Must be comfortable working night shifts with flexibility based on client and operational requirements.

Preferred Qualifications

• Graduate degree in Commerce, Healthcare Administration, Business Administration, or a related field; MBA preferred.
• Certifications such as CPC, CRCR, or Six Sigma are an added advantage.

Performance Expectations

• Maintain AR over 90 days within the target benchmark.
• Drive denial reduction and improve appeal overturn rates.
• Maintain a quality audit score of 95% or higher.
• Achieve client-defined productivity, resolution, and cash collection targets.

Required Skills