RCM Manager

LE9220 Veradigm India Private Limited - Pune; Pune District; On-site; INR 1,400,000 - 2,400,000; Full time

Benefits offered by this job

Quarterly Company-Wide Recharge Days

Peer-based incentive Cheer awards

Tuition Reimbursement Program

Job summary

Veradigm India is seeking a skilled RCM Manager to lead a medical billing team at our Pune office, onsite shift 7:30 PM to 4:30 AM IST. The role focuses on AR optimization, denials management, and client satisfaction through accurate coding and timely collections.

You will monitor daily, weekly, and monthly AR health, review performance with clients, and ensure compliance with CPT/ICD coding standards while driving process improvements and team engagement.

Qualifications

• Bachelor's Degree or equivalent Technical / Business experience.
• 8+ years relevant work experience; 2-3 years at the Expert level or equivalent experience.
• Experience working with India associates or vendor relationships.
• 2-4 years relevant leadership experience.

Responsibilities

• Lead RCM team to maximize accounts receivable collections.
• Monitor AR productivity and health (charge, payments, collections, adjustments) daily/weekly/monthly.
• Ensure accurate CPT/ICD coding, authorizations, patient demographics and payer data.
• Interact with clients and payers; provide timely reports and issue resolution.
• Meet with clients to review billing progress and resolve issues; drive process improvements.

Skills

Team leadership

Accounts Receivable

Medical billing

CPT/ICD coding

Education

Bachelor's Degree or equivalent

Job description

Veradigm Life Veradigm is here to transform health, insightfully. Veradigm delivers a unique combination of point-of-care clinical and financial solutions, a commitment to open interoperability, a large and diverse healthcare provider footprint, along with industry proven expert insights. We are dedicated to simplifying the complicated healthcare system with next-generation technology and solutions, transforming healthcare from the point-of-patient care to everyday life. For more information, please explore Veradigm.com

What will your job look like: RCM Manager This is a fully onsite position in Pune, Maharashtra Office--SHIFT 7:30 PM IST - 4:30 AM IST

Support a Team of Go-Getters

Job Summary

Manages an RCM team who are responsible for all related medical billing activities for the purpose of maximizing accounts receivable collections for clients. In addition to performing similar work, the Manager will oversee and ensure group productivity and performance in accordance with financial goals to ensure the health of the client's Accounts Receivable. Supports RCM Management by efficiently and effectively providing oversight and review of the team, processes and workload.

What you will contribute

Strong customer service skills for client satisfaction, health of client AR and management of RCM team members answering client inquiries; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally acts as primary point of contact for team members and provides guidance on work matters. Track clients’ AR productivity and health (charge, payments, collections, adjustments) on a daily, weekly and/or monthly basis as needed to ensure the client and company expectations are met. Analyze reports to determine when, how and why decrease in clients’ AR; includes denials, unbilled, credit issues, holds; determine corrective actions and communicate with client and staff to resolve. Follow up to ensure actions are taken that achieve the results needed and/or determine other resolution needed. Responsible for staff productivity for follow-up of all unpaid, denied, and underpaid and overpaid claims. This includes but is not limited to contacting insurance companies for claim status, reviewing all insurance claims and patient documentation, reviewing and ensuring appropriate coding, handling correspondence, and making appropriate decisions for follow-up action. Must be effective at handling several accounts simultaneously and ensuring maximum accounts receivable and expedient collection turnaround for clients. Meets with Client representatives to review billing progress, status of accounts and review and resolve any issues presented by clients. Ensures that staff and/or vendor, as applicable, enters all charges into the medical billing system accurately and correctly for reimbursement. This includes but is not limited to: ensuring correct CPT codes, modifiers, and ICD codes, authorizations for services, patient demographics, and health insurance data. Responsible for staff who enter all patient, insurance, and third-party payments into the medical billing system. This includes a thorough knowledge and understanding of medical EOB’s, patient deductibles and co pays, insurance or third-party correspondence, contractual payments and adjustments. Interact with clients and their patients, engage in proactive resolution of issues and timely response to questions and concerns. Deliver timely required reports to the RCM Management; initiates and communicates the resolution of issues. Meet regularly with staff; in-person and as a group to confirm the status of client accounts and build/sustain staff engagement to drive business results and improvements Remain current with company’s policies and procedures regarding AR activity such as, reviewing month end reports to ensure the AR and cash collections are meeting agreed upon benchmarks, identifying trends, reviewing denial reports Review work performed by outside vendors for accuracy and production. Determine changes/improvement needed and works promptly and appropriate with applicable individuals to bring about such changes/improvement. Achieve goals set forth by management and compliance requirements Follows, enforces and models adherence to all policies, procedures and processes

Ideal Candidate

• Bachelor's Degree or equivalent Technical / Business experience (Required)
• 8+ years relevant work experience; 2-3 years at the Expert level or equivalent experience (Preferred)
• Experience working with India associates or vendor relationships (Preferred)
• 2-4 years relevant leadership experience (Preferred)

Benefits

• Quarterly Company-Wide Recharge Days
• Peer-based incentive "Cheer" awards
• Tuition Reimbursement Program

To know more about the benefits and culture at Veradigm, please visit the links mentioned below: https://veradigm.com/about-veradigm/careers/benefits/ https://veradigm.com/about-veradigm/careers/culture/

#LI-SL1 Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.

Thank you for reviewing this opportunity! Does this look like a great match for your skill set? Welcome to Veradigm, where our Mission is transforming health, insightfully. Join the Veradigm team and help solve many of today’s healthcare challenges being addressed by biopharma, health plans, healthcare providers, health technology partners, and the patients they serve. At Veradigm, our primary focus is on harnessing the power of research, analytics, and artificial intelligence (AI) to develop scalable data-driven solutions that bring significant value to all healthcare stakeholders. Together, we can transform healthcare and enable smarter care for millions of people.