AI-Enabled RCM Operations Lead (Remote, Night Shift)

yGen Innovations Inc.; Metro Manila; Remote; PHP 1,800,000 - 2,400,000; Full time

Benefits offered by this job

HMO coverage for you and dependents

Statutory benefits and 13th‑month pay

Certification sponsorship (AAPC, HFMA)

Remote, Philippines‑based, full‑time

Job summary

yGen Innovations Inc. is seeking an experienced RCM Operations Manager to lead end‑to‑end RCM delivery for US healthcare clients from a remote, Philippines‑based setup.

You will own SLAs, coach a delivery team, and partner with our AI/automation initiatives to optimize workflows and KPIs. You should bring 10+ years in US healthcare RCM with 5+ years in senior operations roles, plus hands‑on expertise in A/R follow‑up, denial management, and payer follow‑up across Medicare, Medicaid, and

Qualifications

• 10+ years in US healthcare RCM, including 5+ years in operations leadership at a third‑party RCM or healthcare BPO.
• Deep hands‑on expertise in A/R follow‑up and denial management across Medicare, Medicaid, and commercial payers.
• Proven track record building or scaling an RCM team of 50+ people, including launching new accounts or sites.
• Direct US client‑facing experience: SLA reviews, escalations, onboarding, and quarterly business reviews.
• Strong working knowledge of major PM/EHR systems: Epic, athenahealth, eClinicalWorks, AdvancedMD, Availity, Waystar.

Responsibilities

• Run end‑to‑end RCM delivery across eligibility/benefits, prior authorization, charge entry, claim submission, and A/R follow‑up.
• Own client SLAs and KPIs including days in A/R, clean‑claim rate, denial overturn rate, net collection rate, and productivity targets.
• Build SOPs, payer playbooks, and QA frameworks to drive root‑cause analysis and reduce repeat errors.
• Hire, train, and lead the delivery team with a structured US payer training program and a career ladder.
• Join discovery calls and scoping pilots; support pricing conversations with prospective US clients.
• Run weekly client reports and quarterly business reviews; act as senior escalation point for account issues.
• Enforce HIPAA and BAAs; partner with compliance on SOC 2 readiness.
• Collaborate with yGen's AI team to identify automation opportunities and redesign workflows.

Skills

US Healthcare RCM

Operations leadership

A/R follow-up

Denial management

Team scaling (50+)

US client-facing

SLA/KPI management

Tools

Epic

athenahealth

eClinicalWorks

AdvancedMD

Availity

Waystar

RPA & Automation Tools

KPI & QA Dashboards

Job description

yGen Innovations Inc. is seeking an experienced RCM Operations Manager to lead end‑to‑end RCM delivery for US healthcare clients from a remote, Philippines‑based setup.

You will own SLAs, coach a delivery team, and partner with our AI/automation initiatives to optimize workflows and KPIs. You should bring 10+ years in US healthcare RCM with 5+ years in senior operations roles, plus hands‑on expertise in A/R follow‑up, denial management, and payer follow‑up across Medicare, Medicaid, and