Director of Operations / General Manager (RCM)

Job Title: Director of Operations / General Manager (RCM)
Location: Karachi
Reports To: Management
Shift: Night Shift (to align with US Central Time Zone)

Company Overview

We are a fast-growing Revenue Cycle Management (RCM) company based in Pakistan, providing credentialing, front-office and back-office exclusively to Medical & Dental providers across the United States. We bridge the gap between local operational excellence and US client expectations.

Role Summary

We are seeking a seasoned Director/General Manager to lead our Pakistan-based operational delivery team. This is a high-impact leadership role requiring a candidate who understands the technical nuances of US Medical/Dental RCM (ICD-10, CPT, ADA codes, payer rules) and possesses the executive presence to coordinate strategy with our Business Development team in the USA.

The primary mission is to ensure KPIs are met while facilitating seamless communication between operations (Pakistan) and client acquisition/retention (USA).

Key Responsibilities

1. Operational Leadership (Pakistan)

• Manage and mentor Team Leads, Quality Assurance, and individual contributors (agents) in Medical & Dental RCM functions.
• Maintain and exceed SLA with clients across all service lines.
• Establish daily, weekly, and monthly production targets to ensure clean and timely claim submission.
• Conduct root cause analysis on recurring denials and implement corrective SOPs for US payers (including Medicare, Medicaid, and Commercial insurers).
• Oversee the training curriculum to ensure new hires are HIPAA certified and proficient in US billing and VOB software.
• Conduct audits for new clients on the operational health (AR, causes, possible reductions, etc.)

2. Cross-Functional Coordination with US Business Development

• Act as the primary operational bridge between the Pakistan delivery team and the US-based BD team.
• Participate in weekly US leadership calls to report on operational capacity, quality scores, turnaround times, performance against SLA, etc.
• Provide operational data (e.g., ahead days in verification of benefits, average reimbursement time, denial trends) to the US BD team to help them set accurate client expectations and upsell services.
• Escalate client-specific operational issues to the US BD team before they become churn risks.

3. Client & Quality Assurance

• Review client satisfaction surveys and implement corrective action plans.
• Ensure compliance with HIPAA, OSHA, and data security protocols across the Pakistan office.
• Prepare Monthly Business Reviews (MBRs) for internal stakeholders, linking operational efficiency to revenue growth.

4. People & Culture

• Recruit, retain, and develop top RCM talent in the local market.
• Foster a "client-first" culture that understands the urgency of US healthcare reimbursements.
• Manage shift scheduling, attendance, and performance improvement plans.

Qualifications & Requirements

Experience:

• Minimum 7-10 years of experience in US Revenue Cycle Management (RCM).
• Minimum 4 years in a Team Lead, Manager, or Director role managing teams of 50+ headcount.
• Must have experience handling BOTH Medical and Dental billing (or at least deep Medical experience with working knowledge of Dental).
• Proven track record of reducing AR days and improving denial overturn rates.

Technical Skills:

• Deep knowledge of US Payer policies (Blue Cross, Cigna, Aetna, UnitedHealthcare) and Dental networks (Delta Dental, Cigna Dental).
• Proficiency in at least major RCM software platforms.
• Advanced Excel and Power BI skills for reporting to US stakeholders.

Soft Skills:

• Night shift resilience – ability to lead effectively during US business hours.
• Cross-cultural communication – ability to translate complex operational problems for a non-technical US BD team.
• Problem-solving – proactive in fixing workflow bottlenecks without waiting for US approval.
• Conflict resolution – handling difficult client feedback relayed by the BD team.
• Pressure handling – ability to handle pressure in managing multiple clients with various needs and issues escalating from clients directly or via US BD team.

Education:

• Bachelor’s degree in business, Healthcare Administration, or Finance.
• CPC (Certified Professional Coder) or similar certification is a strong plus.

Success Metrics (KPIs)

• Operational: Verification of Benefits and Eligibility >99%, Clean Claim Rate >98%, AR >90 days <10%, Denial Rate <8%.
• Team: Employee retention rate, training completion rate.
• Coordination: Response time to US BD team queries (<2 hours), accuracy of operational reports.

Job Type: Full-time

Pay: Rs400,000.00 - Rs600,000.00 per month

Work Location: In person