JOB DESCRIPTION

Designation

General Manager – Revenue Cycle Management, Process Control & Insurance/TPA Liaison

Grade

AGM

Location

Corporate Office (with travel across hospital units)

Department

Revenue Cycle Management / Commercial

Reporting To

Chief Commercial Officer

Qualification

Graduate/Postgraduate in Healthcare Management, Finance, Commerce or Business Administration (MBA/MHA preferred)

Professional Experience

12–15 years of progressive experience in Revenue Cycle Management, healthcare finance, or insurance/TPA liaison, with a significant part in a tertiary/quaternary care hospital or health insurance/TPA organization

Main Objective of the Role

To lead end-to-end revenue cycle management, institute robust process controls, drive strategic marketing and business development, and manage insurance/TPA relationships — maximizing revenue realization, minimizing leakage, and enhancing the patient and payer experience across the hospital group.

Key Responsibilities

Revenue Cycle Management

1. Own end-to-end revenue cycle management for all insurance, TPA, and corporate patients across the hospital group.
2. Monitor and control Days Sales Outstanding (DSO), revenue leakage and denial rates.
3. Track and improve collection efficiency, receivables ageing and bad debt provisioning across all units.
4. Drive revenue assurance through periodic audits of billing accuracy, coding and tariff application.

Insurance & TPA Liaison

5. Build and manage strategic relationships with insurance companies, TPAs and corporate clients to enhance empanelment, tariffs and payment terms.
6. Negotiate and renew MoUs/contracts with insurers, TPAs and corporates to secure favorable commercial terms.
7.



Resolve escalated claim disputes, denials and delayed settlements in coordination with the claims and TPA teams.
8. Monitor TPA/insurer performance — turnaround time, denial rates, settlement ratio — and drive corrective engagement.

Marketing & Business Development

9. Develop and execute marketing strategies to drive patient volumes, brand visibility and referral network growth.
10. Identify new business opportunities, including corporate tie-ups, health-check packages and new insurance/TPA empanelments.
11. Collaborate with market aggregators and third party patient financing for business proposition and promotional activities.
12. Track marketing ROI, patient acquisition metrics and campaign effectiveness.

MIS, Reporting & Stakeholder Management

13. Prepare and present dashboards on revenue cycle performance, ageing, denials, TPA/insurer performance and marketing effectiveness to leadership.
14. Lead, train and mentor RCM, billing and liaison teams across locations.
15. Collaborate closely with Finance, Billing, Clinical and Operations teams to ensure smooth cash flow and patient experience.

MIS Reports

1. Revenue Cycle Performance Dashboard
2. Receivables Ageing Report
3. Denial & Short-Payment Analysis Report
4. TPA/Insurer Performance Report
5. Collection Efficiency Report
6. Claims Settlement Tracker
7. Compliance & Process Audit Scorecard
8. Marketing ROI & Patient Acquisition Report
9. Recent Empanelment / Contract Status Report

Supplementary Position Guidelines

Key Relationships

External: Insurance companies, TPAs, Corporates, Marketing/branding agencies, Regulatory bodies

Please Note

Job description is only a general guideline and will change depending on the organizational requirement.

📌 General Manager - Revenue Cycle Management, Process Control & Insurance/TPA Liaison (Thane)
🏢 Jupiter Hospital
📍 Thane