Revenue Cycle Manager

Job description

**Role & responsibilities** - Manage and oversee all revenue cycle operations, including patient registration, insurance verification, medical coding, billing, claims processing, collections, and payment reconciliation. - Ensure accurate and timely submission of insurance and patient claims. - Monitor accounts receivable (AR) and reduce outstanding balances through effective follow-up. - Lead denial management activities by identifying root causes and implementing corrective actions. - Improve clean claim rates and reduce claim rejections. - Coordinate with clinical, finance, coding, and insurance teams to resolve billing issues. - Develop and implement revenue cycle policies, procedures, and best practices. - Monitor key performance indicators (KPIs) such as Days in AR, Collection Ratio, Claim Acceptance Rate, Denial Rate, and Cash Collections. - Ensure compliance with hospital policies, payer requirements, and applicable healthcare regulations. - Conduct regular audits of billing, coding, and reimbursement processes. - Prepare monthly revenue cycle reports and present performance metrics to senior management. - Manage relationships with insurance companies, TPAs, government health schemes, and other payers. - Train, mentor, and evaluate the performance of the RCM team. - Identify opportunities for automation and process improvement to increase operational efficiency. - Support budgeting, forecasting, and financial planning related to revenue cycle operations. **Preferred candidate profile** - Strong knowledge of hospital billing, medical coding (ICD-10, CPT, HCPCS), and insurance claim processes. - Knowledge of government and private insurance reimbursement policies. - Excellent analytical and financial reporting skills. - Strong leadership and team management abilities. - Excellent communication, negotiation, and interpersonal skills. - Advanced proficiency in Microsoft Excel and healthcare management systems. - Ability to manage multiple priorities and meet deadlines