Sr. Manager - Medical Billing
- Pena4 Tech Solutions
- 13 - 17 years
- Hyderabad
- 2 months ago
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Job Description
Sr. Manager US Healthcare Revenue Cycle Management:
As Senior Manager of US Healthcare Revenue Cycle Management oversee the entire financial process from patient registration to payment collection, ensuring efficient billing, claims processing, and revenue collection. This role involves managing teams, establishing standard operating procedures, monitoring key performance indicators (KPIs), and collaborating with cross-functional teams to improve revenue cycle processes and maximize reimbursement.
Key Responsibilities:
Team Leadership:
Oversee and manage a team of revenue cycle professionals, including leaders and individual contributors.
Process Management:
Establish and maintain standard operating procedures, service level agreements, and ensure adherence to policies and regulations.
Performance Monitoring:
Track and analyze daily, weekly, monthly, and quarterly KPIs and productivity, adjusting processes as needed to meet business goals.
Compliance and Audits:
Monitor CMS rules and regulations, Medicare audits, and other regulatory requirements, ensuring compliance and implementing necessary changes.
Denial Management:
Lead denial management programs to identify opportunities to improve payer outcomes and maximize reimbursement.
Collaboration:
Collaborate cross-functionally with internal and external stakeholders, including sales teams, payers, and other departments.
Technology Implementation:
Identify and implement technology enhancements to improve department efficiency and streamline processes.
Escalation Management:
Manage the escalation process for issues, identifying trends and driving resolution for process, team, or payer challenges.
Client Relationship Management:
For roles involving client-facing responsibilities, maintain strong client relationships, provide regular updates, and address client needs.
Revenue Cycle Management:
Oversee the entire revenue cycle process, including patient registration, insurance verification, charge capture, coding, billing, and payment collection.
Skills and Qualifications:
- 10+ years of experience in Facility and Physician RCM in US healthcare.
- A minimum of 5 years of managerial experience.
- Must have managed both Facility and Physician RCM AR follow up Teams & Billing teams with a minimum team size of 100.
- Thorough understanding on RCM functions (AR Follow up/ Charges/Claims/Eligibility/ Authorization/Payment posting/Credit balance).
- Exposure to client interactions and experience conflict resolutions pertains to Process/People Management.
- Excellent Written & Verbal communication skills.
- Driving KPIs as per expectations.
- Understanding & able to present different Dashboards.
- Must be innovative/Flexible/progressive.
- 100% work from Office and work in Night shifts (Flexible towards shift timings).
- Good with Reporting knowledge and able to prepare presentations.
- Required People/Process management skills.
- Experience in EPIC RCM System is an added advantage.
- Excellent people management skills.
- Support Client Partner and Delivery head on Accounts strategic initiatives - Develop strategies or solutions specific to accounts priorities, pain points, or to develop relationship
- Conduct company, executive, and industry specific research insights and prepare the account leadership for their clients meetings
- Program manage accounts growth office Support & track opportunities to the closure, help account leadership team with business case
- Enable and drive the development of strategic account plans, embedding best practice account management principles, including facilitation of account workshops
- Drive financial account planning Annually & Quarterly
- Update CRM with Opportunities and the progress
- Track and report account financials & opportunities. Provide regular pipeline forecasts and business health checks to Senior leaders of the account
- Understanding of business operations and ability to plan, prioritise, multitask, and manage a significant workload under pressure with excellent attention to detail
- Weekly, Monthly & Quarterly Health checks on Accounts growth & Key Initiatives
- Developing strong relationships with internal stakeholders across the firm
- Regular connects with Delivery Portfolio leads on Growth & Delivery aspects of the account
- Prepare success stories upon Project completion, articulating the key benefits & business value delivered to the client
Job Classification
Industry: BPM / BPOFunctional Area / Department: Customer Success, Service & OperationsRole Category: OperationsRole: Operations ManagerEmployement Type: Full timeContact Details:
Company: Pena4 Tech SolutionsLocation(s): Hyderabad
Keyskills: physician billing Denial Management Payment Posting RCM Revenue Cycle Management Operations Manager US Healthcare Manager Facility billing
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Since 2004, Pena4 Tech Solutions has been providing precise and timely customized business data processing outsourcing services that meet international standards. With a full compliment of IT, Financial & Healthcare related professionals, including a wide array of IT Administrators & Program...
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