Division Overview

The Revenue Cycle Management (RCM) division is responsible for managing the financial lifecycle of patient services, from patient registration and insurance verification through charge capture, medical coding, claim submission, payment posting, denial management, accounts receivable follow-up, and final reimbursement. The primary goal of the RCM division is to ensure accurate billing, maximize reimbursement, reduce denials, improve cash flow, maintain regulatory compliance, and enhance operational efficiency. The division works closely with healthcare providers, payers, patients, and internal teams to optimize revenue performance while maintaining high standards of service and compliance.

Role Overview

The Medical Billing Manager is responsible for overseeing and directing all billing and revenue cycle functions to ensure accurate claim submission, timely reimbursement, and compliance with payer and regulatory requirements. This role manages billing staff, optimizes workflows, resolves complex billing issues, and drives continuous improvement to support the financial stability and operational efficiency of the organization. Lead and oversee offshore delivery operations across:

- Patient Access / Eligibility Verification
- Prior Authorization
- Medical Coding
- Charge Entry
- Claims Submission
- Payment Posting
- Accounts Receivable (AR) Follow-up
- Denial Management & Appeals
- Credentialing Support
- Patient Collections / Customer Service
- Revenue Integrity and Reporting
- Ensure operational excellence across multiple Pena4 client accounts, processes, and delivery teams.

Key Responsibilities





Client Relationship Management

Own end-to-end client engagement for assigned healthcare RCM accounts. Build trusted advisor relationships with client leadership teams including CEOs, CFOs, Practice Administrators, Revenue Cycle Directors, and Billing Managers. Conduct regular business reviews, operational governance meetings, and strategic performance discussions. Drive high client satisfaction, retention, and account stability. Act as primary escalation point for operational and relationship issues. Ensure proactive communication and stakeholder management.

Operations & Delivery Oversight

Partner with delivery leaders to ensure achievement of SLA/KPI targets across: AR follow-up Denials management Charge entry Payment posting Eligibility & authorization Coding support Patient collections Monitor operational performance metrics including: Collections Net collection rate Days in AR Aging >90 days Denial rates Productivity & quality Drive operational improvement initiatives and process optimization. Ensure compliance with HIPAA, payer guidelines, and client-specific SOPs.

Revenue Growth & Strategic Account Management

Identify opportunities for account expansion and cross-selling additional RCM services.



Support business development and transition teams during current client onboarding. Develop account growth strategies aligned with client objectives. Drive margin improvement and operational efficiency initiatives. Support contract renewals and commercial discussions.

Governance & Reporting

Prepare executive dashboards, QBR presentations, and operational reports. Lead weekly/monthly governance reviews with internal and external stakeholders. Ensure timely closure of action items, risk mitigation plans, and escalation management. Analyze account trends and provide actionable insights to clients.

Leadership & Team Management

Lead cross-functional operational teams and client services teams. Mentor Assistant Managers, Team Leads. Build a high-performance, accountability-driven culture. Collaborate with HR, Training, Quality, and Transition teams for workforce planning and capability development.

Required Skills & Qualifications

- Experience: 10 15+ years of experience in US Healthcare RCM/BPM operations.
- 5+ years in client operations/account management leadership roles.
- Experience managing mid-to-large US healthcare provider accounts.
- Demonstrated expertise in payer rules, denials management, and compliance (HIPAA, coding guidelines).

Disclaimer : This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.

📌 Sr. Manager (Telangana)
🏢 Pena4 Tech Solutions
📍 Telangana