VP - RCM Operations

Vice President – Operations (Revenue Cycle Management) | Pune
Role Summar
yThe Vice President – Operations will lead end-to-end Revenue Cycle Management (RCM) operations for US healthcare clients from the Pune delivery center. This role will oversee billing, coding, accounts receivable (AR) follow-ups, denial management, payment posting, and client support functions. The incumbent will be responsible for driving operational excellence, owning P&L, ensuring quality and compliance, enhancing team productivity, and delivering high client satisfaction while building scalable processes to support business growth
.Key Responsibilitie
s
Operational Leadersh
ipOwn end-to-end RCM operations including patient access, prior authorization, coding, charge capture, billing, AR follow-up, denial management, payment posting, and write-off
s.Develop and execute operational strategies aligned with client SLAs and organizational objective
s.Ensure seamless coordination across coding, billing, AR, denials, QA, training, and support functions to optimize revenue realization and minimize leakage
s.Design and implement robust SOPs, workflows, and escalation matrices; drive continuous process improvement
s.
Performance & K
PIsDefine, monitor, and improve key RCM metrics such as Days in AR, DSO, clean claim rate, denial rate, first-pass yield, cash collections, AR aging, and old AR reducti
on.Track productivity, quality accuracy, turnaround time (TAT), and SLA adheren
ce.Develop dashboards and reporting frameworks for leadership visibility and client reporti
ng.
AR & Denial Manage
mentLead AR follow-up strategies across commercial, Medicare, and Medicaid pay
ers.Drive denial prevention and resolution through root cause analysis and corrective action pl
ans.Collaborate with coding, clinical, and billing teams to address medical necessity, coding, and documentation-related deni
als.
Client & Stakeholder Manag
ementAct as the primary point of contact for client leadership; lead regular business reviews (QBRs/M
BRs).Build and maintain strong relationships with providers, payers, and internal stakehol
ders.Oversee transitions and onboarding of new clients, ensuring smooth integration into operat
ions.
People Leadership & Capability Bu
ildingLead and mentor operations managers, team leaders, and functional heads across coding, billing, AR, and de
nials.Foster a high-performance culture with clear accountability, defined KPIs, and career development pat
hways.Drive training initiatives on RCM workflows, compliance, SOPs, and leadership develo
pment.
Compliance, Risk &
QualityEnsure adherence to CMS, OIG, HIPAA, and payer-specific regul
ations.Partner with compliance and QA teams to manage audits, corrective action plans, and escal
ations.Implement internal controls for coding accuracy, claims submission, and documentation sta
ndards.
Financial & P&L O
wnershipOwn P&L for the Pune operations/vertical, including revenue, margins, utilization, and cost optim
ization.Drive productivity improvements, resource optimization, and automation initiatives to enhance unit ec
onomics.
Required E
xperience15+ years of progressive experience in healthcare RCM, with at least 5–7 years in senior leadership roles (VP/Director/
Sr. AVP).Proven experience managing large, multi-functional RCM operations (voice and non-voice), including coding, billing, AR, and denial ma
nagement.Experience managing delivery centers in India (Pune preferred) serving US healthcare
clients.Strong understanding of US healthcare payers, coding systems (ICD-10, CPT, HCPCS), and denial managemen
t levers.
Requi
red SkillsStrong operational leadership with the ability to scale teams and
processes.Solid financial acumen with the ability to link RCM performance to business
outcomes.Excellent client-facing and executive communicati
on skills.Data-driven mindset with strong analytical, problem-solving, and change management cap
abilities.Hands-on expertise in claims, denials, authorizations, and coding
processes.
Preferred Qua
lificationsBachelor’s degree in Healthcare Administration, Business, Finance, or a related field; Master’s
preferred.Familiarity with PM/EHR systems such as Epic, NextGen, Athena, or eCli
nicalWorks.Experience in BPO/ITeS or RCM outsourcing environments is highly
desirable.Certifications in Six Sigma, Lean, or other process improvement methodologies
are a plus

Work arrangement
No