•Lead client meetings, operational performance reviews, and executive-level business reviews.
•Monitor AR ageing, collections, cash acceleration, and denial overturn rates to achieve client targets.
•Identify denial root causes and implement corrective actions to reduce repeat denials and revenue leakage.
•Manage high-balance accounts, payer escalations, timely filing issues, and clearinghouse EDI failures.
•Lead and mentor AR Team Leads, Senior Denial Specialists, and Billing Associates.
•Track team productivity, resolution rates, appeal success rates, and quality performance metrics.
•Advise clients on workflow improvements related to patient access, prior authorisation, and insurance verification.
•Ensure compliance with CMS guidelines, Medicare Part B, Medicaid regulations, commercial payer policies, and LCD/NCD guidelines.
•Conduct quality audits, deliver refresher training, and develop SOPs for denial management, payer escalations, and billing processes.
•Plan resource capacity and shift coverage while ensuring operational performance and client satisfaction.
Candidate Requirements:
•8+ years of experience in US Healthcare Revenue Cycle Management (RCM).
•Minimum 3 years of team-handling experience in AR and Denial Management.
•Proven experience independently managing client relationships and executive-level business reviews.
•Strong knowledge of AR ageing, denial management, appeals, payer escalation, and collections.
•Experience in performance management, quality audits, process improvement, and SOP development.
•Hands-on experience with healthcare billing systems, practice management software, clearinghouses, and payer portals.
•Excellent communication, analytical, problem-solving, and leadership skills.
•Must be comfortable working night shifts with flexibility based on client and operational requirements.
