Key Responsibilities
1. SOP Development & Governance
- Draft, author, and publish SOPs for all RCM functions: Charge Entry, Claims Processing, Payment Posting, AR Follow-Up, and Denial Management
- Conduct periodic SOP reviews (quarterly or upon policy/payer/client changes) and maintain strict version control
- Maintain and govern a centralized SOP repository accessible to operations and quality teams
- Facilitate SOP awareness and walkthrough sessions with floor teams and managers to ensure adoption
- Track SOP compliance through audits and flag deviations to operations leadership

2. Process Mapping & Workflow
- Create detailed swim lane flowcharts, process maps, and decision-tree diagrams for all RCM sub-processes
- Document current-state ('As-Is') and future-state ('To-Be') workflows
- Identify bottlenecks, handoff gaps, redundancies, and failure points within existing workflows
- Maintain a structured process library with all maps versioned and linked to corresponding SOPs
- Produce workflow visuals for leadership presentations, client onboarding packs,



and audit readiness reviews

3. Automation Collaboration & BRD Drafting
- Collaborate with the RPA/automation team to translate manual RCM tasks into Business Requirement Documents (BRDs)
- Draft rule-based logic documents for bot development covering tasks such as claim status checks,

ERA/EOB posting, denial categorization, and eligibility verification
- Maintain an automation prospect pipeline by identifying high-volume, rule-based, repetitive tasks across LOBs
- Support UAT (User Acceptance Testing) for automation deployments and provide operational sign-off from a process perspective
- Act as the process SME during bot design discussions, ensuring automation logic aligns with real-world operational workflows

4. Operational Standardization & Floor Support
- Partner with operations managers and teams leads to embed standard processes into day-to-day workflows
- Support new client onboarding by developing

📌 RCM Team Lead (Pune)
🏢 Pune
📍 Pune