RCM Operations Manager

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

About the Role

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

• Talent Pool / Pipeline

• 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

• athenahealth

• eClinicalWorks

• AdvancedMD

• Availity

• Waystar

• RPA & Automation Tools

• KPI & QA Dashboards

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