Sr. Manager

Pena4 Tech Solutions; Hyderabad; Presencial; INR 2.500.000 - 4.200.000; Jornada completa

Descripción de la vacante

Pena4 Tech Solutions in Hyderabad, India is seeking a Medical Billing Manager to oversee the entire billing and revenue cycle function, ensuring accurate claim submission, timely reimbursement, and compliance with payer and regulatory requirements.

You will lead billing staff, optimize workflows, drive continuous improvement, manage offshore delivery across multiple Pena4 client accounts, and build a high-performance team delivering client satisfaction and operational excellence.

Formación

• 10–15+ years of experience in US Healthcare RCM/BPM operations.
• 5+ years in client operations/account management leadership roles.
• Experience managing mid-to-large US healthcare provider accounts.
• Expertise in payer rules, denials management, and HIPAA/compliance.

Responsabilidades

• Own end-to-end client engagement for assigned healthcare RCM accounts.
• Drive client satisfaction, retention, and account stability.
• Oversee offshore delivery operations across RCM domains: Patient Access / Eligibility Verification, Prior Authorization, Medical Coding, Charge Entry, Claims Submission, Payment Posting, AR Follow-up, Denial Management, Appeals, Credentialing Support, Patient Collections / Customer Service.
• Monitor operational performance metrics including: Collections, Net collection rate, Days in AR, >90 days, Denial rates, Productivity, quality.
• Drive operational improvement initiatives and process optimization.
• Ensure compliance with HIPAA, payer guidelines, and client-specific SOPs.
• Revenue Growth: Strategic Account Management, identify opportunities for account expansion and cross-selling.

Conocimientos

US Healthcare RCM/BPM operations

Client operations leadership

Descripción del empleo

Job Summary

Division OverviewThe Revenue Cycle Management (RCM) division is responsible for managing the financial lifecycle of patient services, from patient registration and insurance verification through charge capture, medical coding, claim submission, payment posting, denial management, accounts receivable follow-up, and final reimbursement.The primary goal of the RCM division is to ensure accurate billing, maximize reimbursement, reduce denials, improve cash flow, maintain regulatory compliance, and enhance operational efficiency. The division works closely with healthcare providers, payers, patients, and internal teams to optimize revenue performance while maintaining high standards of service and compliance.

Role OverviewThe Medical Billing Manager is responsible for overseeing and directing all billing and revenue cycle functions to ensure accurate claim submission, timely reimbursement, and compliance with payer and regulatory requirements. This role manages billing staff, optimizes workflows, resolves complex billing issues, and drives continuous improvement to support the financial stability and operational efficiency of the organization. Lead and oversee offshore delivery operations across:Patient Access / Eligibility Verification Prior Authorization Medical Coding Charge Entry Claims Submission Payment Posting Accounts Receivable (AR) Follow-up Denial Management Appeals Credentialing Support Patient Collections / Customer Service Revenue Integrity and Reporting Ensure operational excellence across multiple Pena4 client accounts, processes, and delivery teams.

Key Responsibilities

• Client Relationship Management
• Own end-to-end client engagement for assigned healthcare RCM accounts.
• Build trusted advisor relationships with client leadership teams including CEOs, CFOs, Practice Administrators, Revenue Cycle Directors, and Billing Managers.
• Drive high client satisfaction, retention, and account stability.
• Act as primary escalation point for operational and relationship issues.
• Ensure proactive communication and stakeholder management.
• Operations Delivery Oversight
• Partner with delivery leaders to ensure achievement of SLA/KPI targets across: AR follow-up Denials management Charge entry Payment posting Eligibility authorization Coding support Patient collections
• Monitor operational performance metrics including: Collections Net collection rate Days in AR Aging >90 days Denial rates Productivity quality
• Drive operational improvement initiatives and process optimization.
• Ensure compliance with HIPAA, payer guidelines, and client-specific SOPs.
• Revenue Growth
• Strategic Account Management
• Identify opportunities for account expansion and cross-selling additional RCM services.
• Support business development and transition teams during new client onboarding.
• Develop account growth strategies aligned with client objectives.
• Drive margin improvement and operational efficiency initiatives.
• Support contract renewals and commercial discussions.
• Governance Reporting
• Prepare executive dashboards, QBR presentations, and operational reports.
• Lead weekly/monthly governance reviews with internal and external stakeholders.
• Ensure timely closure of action items, risk mitigation plans, and escalation management.
• Analyze account trends and provide actionable insights to clients.
• Leadership Team Management
• Lead cross-functional operational teams and client services teams.
• Mentor Assistant Managers, Team Leads.
• Build a high-performance, accountability-driven culture
• Collaborate with HR, Training, Quality, and Transition teams for workforce planning and capability development.
• Ensure operational excellence across multiple Pena4 client accounts, processes, and delivery teams.

Required Skills and Qualifications

• Experience: 10-15+ years of experience in US Healthcare RCM/BPM operations.
• 5+ years in client operations/account management leadership roles.
• Experience managing mid-to-large US healthcare provider accounts.
• Demonstrated expertise in payer rules, denials management, and compliance (HIPAA, coding guidelines).