Director - Revenue Cycle Management Operations

Key Responsibilities:

Strategic Leadership & Planning:

- Own the RCM operations function end-to-end including medical billing, coding, AR follow-up, payment posting, and denial management.

- Define long-term operational strategy and business goals in alignment with organizational objectives.

- Drive transformation initiatives to improve automation, accuracy, and turnaround times.

- Provide thought leadership to senior management on RCM trends, analytics, and best practices.

Team Management & Performance:

- Lead a team of Operations Managers, Team Leads, and RCM associates spread across multiple locations or clients.

- Set KPIs, monitor performance metrics, and implement action plans to meet SLAs and improve team productivity.

- Create and nurture a performance-driven, collaborative, and accountable team culture.

- Manage hiring, training, and career development programs across RCM verticals.

Client Engagement & Relationship Management:

- Serve as the primary point of contact for key clients, ensuring high levels of satisfaction and retention.

- Conduct regular governance calls, business reviews, and share dashboards/reports with clients.

- Handle escalations and deliver timely resolutions in coordination with cross-functional teams.

Operational Excellence & Compliance:

- Oversee compliance with HIPAA and other regulatory frameworks.

- Ensure adherence to client-specific and internal policies for quality assurance and data protection.

- Continuously monitor workflows, identify gaps, and implement lean practices or automation tools.

- Collaborate with technology and analytics teams to improve reporting accuracy and dashboard visibility.

Financial Management:

- Manage operational budgets, cost controls, and resource utilization to improve profitability.

- Work with finance teams to forecast revenue and expenses related to RCM operations.

Required Skills & Qualifications:

- Bachelors degree in Healthcare Administration, Business, Finance or related field (Masters preferred).

- Minimum 10 years of experience in healthcare RCM with at least 5 years in a senior leadership role.

- Proven experience in managing large RCM operations for US healthcare clients.

- Deep knowledge of the entire RCM lifecycle, CPT/ICD-10 coding, payer guidelines, and denial management.

- Strong leadership, analytical, and strategic thinking abilities.

- Experience in using RCM software like Athena, Epic, NextGen, eClinicalWorks, or similar platforms.

- Excellent communication and stakeholder management skills.

Preferred:

- Certified Revenue Cycle Representative (CRCR) or other relevant certifications.

- Experience in setting up new RCM processes or leading transitions/migrations.