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RCM Process Expert (Process Improvement & Quality) - Manager

External
acurussolutions logoAcurussolutions · Royapettah, India
Full-timeOn-site1mo ago30+ days old, may be filled
ComplianceDocumentationLeadershipLeanProcess ImprovementSix Sigma
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About the role

As the RCM Process Expert (Manager) , you will be the primary catalyst for operational excellence across our end-to-end US Healthcare Revenue Cycle operations. Reporting to the Head of RCM, you will hold a high-visibility role responsible for identifying revenue leakages and transforming workflows to maximize provider reimbursements. This is an exciting opportunity for a domain expert to bridge the gap between "business as usual" and "best-in-class," utilizing Lean Six Sigma methodologies to influence large-scale operations and drive measurable financial impact.

Responsibilities

  • Optimize Workflows: Review and streamline end-to-end RCM processes, including Patient Access, Coding, Billing, AR, and Denials.
  • Identify Revenue Gaps: Proactively detect revenue leakages, quality bottlenecks, and operational inefficiencies across the billing lifecycle.
  • Lead Improvement Projects: Execute high-impact Lean / Six Sigma projects to improve First Pass Clean Claim rates and reduce overall cost-to-collect.
  • Conduct Deep-Dive RCA: Perform rigorous Root Cause Analysis on claim denials and rejections to implement permanent corrective actions.
  • Standardize Operations: Create and govern standardized SOPs, quality checklists, and internal controls to ensure consistency across RCM teams.
  • Manage Quality Metrics: Define and track critical KPIs such as Net Collection Ratio, Days in AR, and Defect Rates.
  • Support Audits: Partner with internal and client teams to ensure audit readiness and compliance with US healthcare billing standards.
  • Cross-Functional Synergy: Collaborate with Training and Automation teams to identify manual tasks that can be optimized through RPA or AI tools.
  • Drive Quality Culture: Benchmarking internal performance against industry standards to foster a culture of continuous improvement.
  • Stakeholder Influence: Present process improvement findings and ROI reports to senior leadership and client stakeholders.

Requirements

  • 7-12 years of hands-on US Healthcare RCM experience is required.
  • Deep domain expertise in Provider RCM workflows is required.
  • Proven track record in process improvement and quality management is required.
  • Strong analytical and documentation skills with proficiency in data presentation is required.
  • Lean / Six Sigma Black Belt is required.
  • Experience managing large or multi-client RCM operations (preferred).
  • Exposure to automation, RPA, or advanced workflow analytics tools (preferred).

Benefits

Stock-options packageHealth benefits include medical, dental and vision401KLong-term disabilityUnlimited PTOLife insurancePaid Leave Program👉[include as needed for clinic positions]Location & Specialties hiring:👉 [include as needed] Physical Demands: Mostly sedentary work duties require exerting up to thirty pounds of force occasionally and/or small amounts of force frequently. Sedentary work typically involves sitting most of the time but may involve walking or standing for brief periods.Health insuranceDental insuranceVision insurance401(k)Paid time offEquity / stock options

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