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 solid 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

📌 VP - RCM Operations (Pune)
🏢 r3 Consultant
📍 Pune