Job Description

Associate Director - Revenue Cycle Management (RCM)

Job Summary

Key Responsibilities

• Lead and manage end-to-end US healthcare RCM operations, including billing, coding, charge entry, payment posting, AR follow-up, denial management, and collections.
• Develop and execute strategic business plans to improve revenue cycle performance, operational efficiency, and financial outcomes.
• Manage large-scale RCM operations, ensuring achievement of business goals, client expectations, and operational targets.
• Establish operational governance, performance management frameworks, and continuous improvement initiatives.

• Monitor and improve key performance indicators (KPIs), including Days in AR, Net Collection Rate, First Pass Resolution Rate, Denial Rate, AR Aging, and Clean Claim Rate.
• Identify revenue leakage, process inefficiencies, and operational bottlenecks and implement corrective actions.
• Drive initiatives to improve collections, reduce outstanding AR, minimize denials, and optimize reimbursement.
• Develop strategies to improve cash flow and overall financial performance.

• Build and maintain strong relationships with US healthcare clients, providers, payers, and other stakeholders.
• Manage client escalations, conduct business reviews, and ensure delivery against contractual SLAs.
• Collaborate with payer representatives to resolve reimbursement issues, claims disputes, and payment discrepancies.
• Support payer contract reviews, reimbursement analysis, and negotiation strategies.

• Ensure compliance with applicable US healthcare regulations, including HIPAA, CMS guidelines, and payer-specific billing requirements.
• Oversee coding and billing accuracy in accordance with applicable ICD-10-CM, CPT, and HCPCS guidelines.
• Conduct regular audits, quality reviews, and compliance assessments.
• Implement corrective and preventive action plans to address quality and compliance gaps.

• Identify and implement technology solutions, automation, and analytics tools to streamline RCM operations.
• Drive process standardization, automation, and digital transformation initiatives.
• Leverage data analytics and reporting tools to support strategic decision-making.
• Collaborate with IT and business teams to enhance RCM platforms and operational reporting capabilities.

• Lead, mentor, and develop senior managers, operational leaders, and large RCM teams.
• Establish performance objectives, productivity benchmarks, and development plans.
• Build a high-performance culture focused on accountability, operational excellence, and continuous improvement.
• Drive succession planning, leadership development, and employee engagement initiatives.

• Prepare and present operational, financial, and strategic performance reports to senior leadership.
• Conduct regular business reviews and provide actionable insights on revenue cycle performance.
• Develop annual operating plans, budgets, and resource utilization strategies.
• Identify opportunities for business growth, operational expansion, and service delivery improvements.

Required Qualifications & Experience

• Bachelor's degree in Healthcare Management, Business Administration, Finance, or a related discipline. Master's degree / MBA is preferred.
• 14+ years of experience in US healthcare Revenue Cycle Management.
• Minimum 5 years of experience in senior leadership roles such as Senior Manager, Associate Director, Director, or equivalent.
• Strong experience managing large-scale US healthcare RCM operations.
• Proven expertise in end-to-end RCM processes, including:
  • Medical Billing and Claims Management
  • AR Management and Collections
  • Denial Management and Appeals
  • Payment Posting and Reconciliation
  • Medical Coding and Charge Capture
  • Eligibility Verification and Prior Authorization
  • Payer Relations and Reimbursement Management
• Strong understanding of US healthcare reimbursement models, payer guidelines, and regulatory requirements.
• Experience managing client relationships, operational SLAs, financial performance, and business reviews.
• Demonstrated ability to drive operational transformation, automation, and process improvement initiatives.

Key Competencies

• Strategic thinking and business acumen
• Strong leadership and people management skills
• Excellent analytical and problem-solving abilities
• Strong communication, negotiation, and stakeholder management skills
• Data-driven decision-making and performance management
• Client-centric approach and operational excellence
• Ability to manage complex business challenges and deliver measurable results

Preferred Experience

• Experience working with US healthcare providers, hospitals, physician groups, and healthcare RCM service providers.
• Exposure to multiple specialties, including Physician Billing, Hospital Billing, and Specialty Billing.
• Experience with RCM platforms such as Epic, Cerner, Athenahealth, eClinicalWorks, NextGen, or similar systems.
• Experience in managing multi-client or multi-site RCM operations.
• Exposure to automation, AI-driven RCM solutions, and advanced analytics.

Success Metrics

• Improvement in Net Collection Rate and First Pass Resolution Rate.
• Reduction in Days in AR, denial rates, and aged AR.
• Achievement of client SLAs and operational targets.
• Revenue optimization and reduction in revenue leakage.
• Improvement in productivity, quality, and operational efficiency.
• Client satisfaction, employee engagement, and business growth.