POSITION SUMMARY The Transition Manager is responsible for planning, coordinating, and executing end-to-end transitions of Revenue Cycle Management (RCM) operations for US healthcare clients. This includes onboarding new clients, migrating processes from in-house or incumbent vendors, stabilizing operations post-transition, and ensuring seamless knowledge transfer across all RCM functionsfrom Patient Access and Charge Entry through Coding, Billing, Payment Posting, Accounts Receivable, Denial Management, and Credit Balance Resolution. The role demands strong project management rigor, deep domain expertise in US healthcare billing, and the ability to manage cross-functional teams across onshore and offshore locations.

KEY RESPONSIBILITIES

Transition Planning & Execution

- Lead end-to-end RCM transition projects including discovery, due diligence, process mapping, resource planning, technology setup, and go-live execution.
- Develop detailed transition plans with milestones, RACI matrices, risk registers, and communication frameworks aligned to client contractual timelines.
- Coordinate parallel-run and shadow-billing phases to validate accuracy before full cutover.
- Manage transitions across multiple RCM functions: Patient Access/Scheduling, Charge Entry, Coding (Professional & Facility), Claims Submission, Payment Posting, AR Follow-Up, Denial/Rejection Management, Credit Balance, and Patient Collections.

Knowledge Transfer & Process Documentation

- Design and execute structured Knowledge Transfer (KT) plans covering process workflows, payer-specific rules, system navigation, and exception handling.
- Create and maintain Standard Operating Procedures (SOPs), desktop procedures, training manuals, and quick-reference guides for each RCM sub-process.
- Conduct Train-the-Trainer sessions and competency assessments to ensure operational readiness.

Stakeholder & Client Management

- Serve as the primary point of contact for clients, incumbent vendors, and internal delivery teams during the transition lifecycle.
- Conduct regular status reviews, steering committee meetings, and executive updates with data-driven dashboards.
- Manage client expectations, escalation paths, and change requests with professionalism and transparency.

Technology & Systems Integration

- Coordinate EHR/PM system access provisioning, user configuration, and integration testing (e.g., EPIC, Cerner, Allscripts/Veradigm, eClinicalWorks, NextGen, athenahealth).
- Oversee clearinghouse enrollment, EDI setup (837/835/276/277),



payer portal access, and ERA/EFT enrollment.
- Validate charge capture interfaces, claim scrubbing rules, and remittance auto-posting configurations.

Quality Assurance & Stabilization

- Define and monitor transition KPIs including claim acceptance rates, first-pass resolution, denial rates, days in AR, and cash collections against benchmarks.
- Implement a 30-60-90 day post-transition stabilization plan with defined quality gates and corrective action triggers.
- Apply Lean Six Sigma methodologies (DMAIC, root cause analysis, process capability analysis) to identify and eliminate transition defects.

Compliance & Risk Management

- Ensure all transition activities comply with HIPAA, False Claims Act, Anti-Kickback Statute, OIG guidelines, and state-specific billing regulations.
- Conduct risk assessments at each transition phase and maintain mitigation plans with clearly assigned ownership.
- Coordinate PHI data migration and access controls in compliance with organizational security policies.

REQUIRED QUALIFICATIONS

Education

- Bachelor’s degree in Healthcare Administration, Business Administration, Health Informatics, or a related field (required).
- MBA or Master’s degree in Healthcare Management, Business, or Operations (strongly preferred).

Certifications (One or More Required)

- PMP (Project Management Professional) – PMI
- Lean Six Sigma Green Belt or Black Belt certification
- Additional valued certifications: CPCO, CPC, CRCR (HFMA), CHFP, FHFMA

Experience

- Minimum 10–15 years of progressive experience in US Healthcare Revenue Cycle Management operations.
- At least 5 years in a transition management, program management, or implementation leadership role within an RCM services company or health system.
- Demonstrated experience managing end-to-end RCM transitions for multi-specialty physician groups, hospitals, or health systems.
- Hands-on expertise across the full RCM lifecycle: Patient Access, Eligibility Verification, Prior Authorization, Charge Capture, Coding (CPT/ICD-10/HCPCS), Claims Submission, Payment Posting, AR Management, Denial Management, Appeals,



Credit Balance, and Patient Statements.
- Experience managing onshore-offshore delivery models with geographically distributed teams.

REQUIRED SKILLS & COMPETENCIES

- Project Management: Expert-level proficiency in project planning, scheduling (MS Project, Smartsheet), resource allocation, risk management, and stakeholder communication.
- RCM Domain Mastery: Deep knowledge of payer contracts, fee schedules, CARC/RARC codes, CMS regulations, Medicare/Medicaid billing rules, commercial insurance workflows, and specialty-specific billing nuances.
- Process Improvement: Proven ability to apply Lean Six Sigma tools (DMAIC, value stream mapping, control charts, Pareto analysis) to optimize RCM workflows and reduce transition cycle times.
- Technology Proficiency: Working knowledge of major EHR/PM platforms (EPIC, Cerner, Allscripts, NextGen, athenahealth, eClinicalWorks), clearinghouses (Availity, Waystar, Change Healthcare), and RCM analytics tools.
- Data & Analytics: Ability to build and interpret operational dashboards, productivity trackers, and financial reports using Excel (advanced formulas, pivot tables, VBA), SQL, and BI tools (Power BI, Tableau).
- Leadership: Strong team leadership with experience managing 30–80+ FTEs across multiple functions and geographies during high-pressure transition periods.
- Communication: Exceptional written and verbal communication skills for executive presentations, SOPs, training materials, and client-facing deliverables.
- Change Management: Experience driving organizational change, managing resistance, and fostering adoption of new processes and technologies.

PREFERRED QUALIFICATIONS

- Experience with large-scale RCM transitions involving 100+ FTE ramp-ups or multi-site implementations.
- Familiarity with RPA/automation tools (UiPath, Power Automate) and AI-assisted coding/billing technologies.
- Knowledge of value-based care models, bundled payments, and population health revenue cycle implications.
- Prior consulting experience with Big 4 or specialized healthcare advisory firms is a plus.
- Experience with SOC 2 / HITRUST compliance frameworks in an outsourced RCM environment.

COMPENSATION & BENEFITS Competitive base salary commensurate with experience, plus performance-based bonus. Comprehensive benefits package including health/dental/vision insurance, 401(k) with employer match, paid time off, career development allowance, and certification reimbursement.

📌 Walk-in || Transition Manager (Chennai)
🏢 Hrcs Services
📍 Chennai