RCM Lead

Job Purpose

The RCM Lead is responsible for overseeing the entire revenue cycle management process for the organisation, focusing on medical billing, claims processing, payment posting, denial management, and compliance. This position ensures that the company maximises revenue while maintaining accuracy, efficiency, and compliance with healthcare regulations.

Key Responsibilities

• Lead, manage, and mentor the revenue cycle team, including billing specialists and AR follow-up staff.
• Develop and implement policies and procedures for efficient billing and collections.
• Monitor and analyse key performance metrics (e.g., AR days, denial rates, collections).
• Oversee claim submissions, payment posting, and follow-up to ensure timely reimbursement.
• Work together to resolve billing disputes and denials with internal teams, payers, and providers.
• Ensure compliance with federal, state, and payer-specific billing regulations.
• Prepare financial and operational reports for senior management.
• Identify process improvement opportunities to optimise revenue cycle performance.
• Stay current with industry changes, payer requirements, and best practices in medical billing and RCM.

Requirements

• A bachelor's degree in Healthcare Administration, Business, Finance, or a related field, or equivalent experience, is required.
• 3+ years of experience in medical billing and revenue cycle management.
• The candidate should possess a robust understanding of healthcare reimbursement, payer regulations, and compliance standards.
• Proficiency in medical billing software and electronic health record (EHR) systems.
• Excellent leadership, communication, and analytical skills.
• Ability to work in a fast-paced, results-driven environment.

Performance Expectations

• Maintain AR days below industry benchmarks.
• Achieve a high rate of clean claim submissions.
• Reduce denial rates through proactive management and root cause analysis.
• Improve overall collection rates and financial performance.

Job Type: Full-time

Pay: Rs80,000.00 - Rs150,000.00 per month

Work Location: In person