Healthcare RCM Operations Manager

yGen Innovations Inc; Metro Manila; Remote; PHP 3,776,000 - 5,664,000; Full time

Benefits offered by this job

Performance bonus

HMO coverage

13th-month pay

Certification sponsorship

Job summary

Clicktek Consulting and yGen Innovations are building an AI-enabled RCM operation for US healthcare clients. We seek a seasoned RCM Operations Manager with hands-on experience in A/R follow-up, denial management, and scaling an RCM team from the ground up.

You will own client SLAs, develop payer playbooks, and lead the delivery team while supporting discovery calls and pricing discussions. This remote, nightshift role is Philippines-based and open to hybrid arrangements.

Qualifications

• 10+ years in US healthcare RCM with 5+ years in operations leadership.
• Deep hands-on expertise in A/R follow-up and denial management across Medicare, Medicaid, and commercial payers.
• Experience building or scaling an RCM team of 50+ people, ideally including launching a new account or site.
• Direct US client-facing experience: SLA reviews, escalations, onboarding, and quarterly business reviews.
• Strong knowledge of major PM/EHR and clearinghouse systems.

Responsibilities

• Run end-to-end RCM delivery across eligibility and benefits, prior authorization, charge entry, claim submission, payment posting, A/R follow-up and denial management.
• Own client SLAs and KPIs including DSO, clean-claim rate, denial overturn rate, net collection rate, and productivity targets.
• Build SOPs, payer-specific playbooks, and QA frameworks to drive root-cause analysis and reduce repeats.
• Hire, train, and lead the delivery team with a structured US-payer training program and career ladder.
• Join discovery calls and support pricing conversations with prospective US clients as the delivery expert.
• Run weekly client reports and quarterly business reviews; act as senior escalation point for account issues.
• Ensure HIPAA compliance and SOC 2 readiness; partner with compliance lead.
• 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

Client-facing experience

Tools

Epic

athenahealth

eClinicalWorks

AdvancedMD

Availity

Waystar

RPA Automation Tools

Job description

Clicktek Consulting and yGen Innovations deliver end-to-end RPO (Recruitment Process Outsourcing) services to enterprise clients across multiple industries. Our team works embedded with client organizations to solve complex talent and technology challenges at scale.

We're building RCM Operations Managers to found and lead a new AI-enabled revenue cycle management service for US healthcare clients. If you have deep hands-on expertise in A/R follow-up, denial management, and building RCM teams from the ground up, we want to hear from you.

• Remote (Philippines-based), open to Hybrid
• Nightshift, covering full US business hours
• Senior Leadership with 10+ years in US Healthcare RCM

What the Work Looks Like

Depending on the engagement, RCM Operations Managers typically work on:

• Running end-to-end RCM delivery across eligibility and benefits, prior authorization, charge entry, claim submission, payment posting, A/R follow-up, and denial management
• Owning client SLAs and KPIs including days in A/R, clean-claim rate, denial overturn rate, net collection rate, and productivity and accuracy targets
• Building SOPs, payer-specific playbooks, and QA sampling frameworks that drive root-cause analysis and reduce repeat errors
• Hiring, training, and leading the delivery team, including designing a structured training program on US payers and a career ladder from agent to team lead
• Acting as the delivery expert in sales by joining discovery calls, scoping pilots, and supporting pricing conversations with prospective US clients
• Running weekly client reports and quarterly business reviews, and serving as the senior escalation point for account issues
• Enforcing HIPAA requirements and client business associate agreements on the floor, and partnering with the compliance lead on SOC 2 readiness
• Partnering with yGen's AI team to identify automation opportunities, test AI agents on the floor, and redesign workflows around them

What We Look For

Must Have

• Availability to work nightshift hours aligned to US business hours
• 10+ years in US healthcare RCM, including 5+ years in operations leadership (Operations Manager, Senior Operations Manager, or Director level) at a third-party RCM or healthcare BPO provider
• Deep hands-on expertise in A/R follow-up, denial management, and payer follow-up across Medicare, Medicaid, and commercial payers
• Track record building or scaling an RCM team of 50 or more people, ideally including launching a new account or site
• Direct US client-facing experience: SLA reviews, escalations, client onboarding, and quarterly business reviews
• Strong working knowledge of major PM/EHR and clearinghouse systems such as Epic, athenahealth, eClinicalWorks, AdvancedMD, Availity, and Waystar

Strong Advantage

• Experience running HIPAA-compliant operations and taking part in client or SOC 2 audits
• Comfortable building and running KPI dashboards, with a solid grasp of gross margin and staffing math
• Hands-on experience applying RPA, automation, or AI tools within RCM operations
• Excellent written and spoken English communication, with experience engaging directly with US executives

Nice to Have

• Certifications such as CPC (AAPC), CRCR (HFMA), or Lean Six Sigma
• Background in medical coding, prior authorization, or end-to-end RCM service lines
• Experience opening a provincial delivery site (e.g. Dumaguete, Bacolod, Iloilo, Davao)

Tools and Platforms We Work With

Experience with any of these is a strong advantage. You do not need all of them.

• Epic
• eClinicalWorks
• AdvancedMD
• Availity
• Waystar
• RPA & Automation Tools

Why Join Us

• A founding seat in a new AI-enabled RCM business line, with direct access to group leadership
• Performance bonus tied to revenue, gross margin, and client retention, on top of a competitive base salary
• HMO coverage for you and your dependents, plus statutory benefits and 13th-month pay
• Certification sponsorship (AAPC, HFMA) and a genuine builder's mandate to hire, train, and scale the team from zero
• Remote, full-time setup for Philippines-based candidates, open to hybrid