Vice President DME RCM (Jaipur)

Knack RCM; Jaipur; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

Knack RCM seeks an accomplished Operations Leader to drive end-to-end DME Revenue Cycle Management for US healthcare clients from India. You will lead large teams, orchestrate governance, and deliver on KPIs for revenue, collections, and service quality.

You will partner with executives, optimize processes with Lean Six Sigma, and shape strategic client relationships while ensuring profitability and scalable growth for the DME billing unit.

Qualifications

• 15+ years of experience in US Healthcare Revenue Cycle Management.
• Extensive leadership experience in DME Billing Operations.
• Minimum 8+ years in senior leadership roles such as Director, Senior Director, AVP, or VP.
• Proven experience managing large-scale DME Revenue Cycle operations.
• Strong expertise in: DME Billing, Insurance Verification, Prior Authorization, Accounts Receivable Management, Denial Management, Payment Posting, Medicare & Medicaid Billing, Revenue Optimization, Client Management.
• Demonstrated ability to manage P&L and drive business profitability.
• Strong experience leading operational transformation and automation initiatives.
• Proven success managing strategic client relationships and executive-level stakeholders.

Responsibilities

• Lead end-to-end DME Revenue Cycle Management operations across multiple clients and business units.
• Develop and execute operational strategies aligned with organizational objectives.
• Ensure achievement of KPIs related to revenue, collections, productivity, quality, and service delivery.
• Drive continuous process improvement and operational excellence initiatives.
• Oversee workforce planning, capacity management, and resource optimization.
• Establish governance frameworks to monitor operational performance and business outcomes.
• Oversee Insurance Verification, Benefits Investigation, Prior Authorization, Intake, Billing, Payment Posting, Denial Management, Appeals, and AR Follow-up functions.
• Improve clean claim rates and reduce claim rejections and billing errors.
• Drive reductions in AR aging and outstanding inventory.
• Ensure timely reimbursement and cash flow optimization.
• Analyze payer-specific trends and implement corrective action plans.
• Develop revenue recovery strategies for denials, underpayments, and aging accounts.
• Act as the executive point of contact for strategic DME clients.
• Conduct Executive Reviews, Quarterly Business Reviews (QBRs), and governance meetings.
• Ensure delivery against contractual obligations, KPIs, and SLAs.
• Build long-term client partnerships and drive client retention initiatives.
• Manage escalations and ensure timely resolution.
• Identify opportunities to expand services and grow existing client relationships.

Skills

DME Billing

Insurance Verification

Prior Authorization

Accounts Receivable Management

Denial Management

Payment Posting

Medicare & Medicaid Billing

Revenue Optimization

Client Management

P&L Management

Operational Transformation

Automation initiatives

Education

Bachelor's Degree

MBA / MHA / Postgraduate Degree

Job description

Role & responsibilities

Operations Leadership

• Lead and manage end-to-end DME Revenue Cycle Management operations across multiple clients and business units.
• Develop and execute operational strategies aligned with organizational objectives.
• Ensure achievement of key performance indicators related to revenue, collections, productivity, quality, and service delivery.
• Drive continuous process improvement and operational excellence initiatives.
• Oversee workforce planning, capacity management, and resource optimization.
• Establish governance frameworks to monitor operational performance and business outcomes.

Revenue Cycle Management

• Oversee Insurance Verification, Benefits Investigation, Prior Authorization, Intake, Billing, Payment Posting, Denial Management, Appeals, and AR Follow-up functions.
• Improve clean claim rates and reduce claim rejections and billing errors.
• Drive reductions in AR aging and outstanding inventory.
• Ensure timely reimbursement and cash flow optimization.
• Analyze payer-specific trends and implement corrective action plans.
• Develop revenue recovery strategies for denials, underpayments, and aging accounts.

Client Relationship Management

• Act as the executive point of contact for strategic DME clients.
• Conduct Executive Reviews, Quarterly Business Reviews (QBRs), and governance meetings.
• Ensure delivery against contractual obligations, KPIs, and SLAs.
• Build long-term client partnerships and drive client retention initiatives.
• Manage escalations and ensure timely resolution.
• Identify opportunities to expand services and grow existing client relationships.

Financial Management

• Own the P&L; for the DME Billing business unit.
• Drive revenue growth, profitability, and operational efficiency.
• Develop and manage departmental budgets, forecasting, and financial plans.
• Monitor business performance against revenue and margin targets.
• Identify automation and cost optimization opportunities to improve ROI.
• Drive year-over-year improvements in revenue and profitability.

Compliance & Risk Management

• Ensure compliance with:
• HIPAA Regulations
• CMS Guidelines
• Medicare Requirements
• Medicaid Regulations
• Commercial Payer Policies
• Internal Audit Standards
• Drive audit readiness and compliance governance initiatives.
• Establish robust controls to mitigate operational and regulatory risks.
• Ensure adherence to documentation standards and data security policies.

Leadership & Talent Development

• Lead large teams consisting of Directors, Associate Directors, Senior Managers, Managers, and Operations Leaders.
• Build leadership pipelines and succession planning frameworks.
• Drive employee engagement, retention, and performance management initiatives.
• Mentor senior leaders and foster a high-performance culture.
• Develop training and capability-building programs across operations.

Process Excellence & Transformation

• Lead digital transformation and automation initiatives.
• Drive Lean Six Sigma and continuous improvement programs.
• Implement workflow optimization and productivity enhancement projects.
• Evaluate emerging technologies, automation tools, and vendor solutions.
• Improve scalability, quality, and operational efficiency through innovation.

Business Growth & Innovation

• Partner with Business Development and Sales teams to support growth initiatives.
• Participate in RFP responses, solution design, and client presentations.
• Identify current revenue streams, service offerings, and market opportunities.
• Support client onboarding, transitions, and business expansion projects.
• Build scalable operational frameworks to support future growth.

Desired Candidate Profile

Mandatory Requirements

• 15+ years of experience in US Healthcare Revenue Cycle Management.
• Extensive leadership experience in DME Billing Operations.
• Minimum 8+ years in senior leadership roles such as Director, Senior Director, AVP, or VP.
• Proven experience managing large-scale DME Revenue Cycle operations.
• Strong expertise in:
• DME Billing
• Insurance Verification
• Prior Authorization
• Accounts Receivable Management
• Denial Management
• Payment Posting
• Medicare & Medicaid Billing
• Revenue Optimization
• Client Management
• Demonstrated ability to manage P&L; and drive business profitability.
• Strong experience leading operational transformation and automation initiatives.
• Proven success managing strategic client relationships and executive-level stakeholders.

Educational Qualification

• UG: Bachelor's Degree (Mandatory)
• PG: MBA / MHA / Any Postgraduate Degree (Preferred) .