Job Roles & Responsibilities • Client facing role to lead and manage end-to-end RCM-related projects including but not limited to billing, coding, claims processing, denials management, and payer integration. • Collaborate with cross-functional teams including clinical, finance, IT, compliance, and external vendors. • Define project scope, goals, deliverables, timelines, and success metrics. • Develop detailed project plans using standard project management tools (e.g., MS Project, JIRA, Asana). • Monitor project performance, identify risks, and implement mitigation strategies. • Identify the business opportunities and work with client to convert to contracts. • Ensure compliance with HIPAA, CMS regulations, and internal policies. • Drive process improvement initiatives to optimize reimbursement and reduce revenue leakage. • Prepare and present project status reports to leadership and stakeholders. • Facilitate Agile ceremonies (if applicable) – sprint planning, stand-ups, retrospectives. • Manage budgets, resources, and third-party vendors where applicable. Candidate Requirements • Bachelors degree in Healthcare Administration, Business, IT, or a related field. • 10+ years of project management experience in the healthcare RCM domain. • Strong knowledge of healthcare billing, coding (ICD, CPT, HCPCS), EDI transactions, Payment posting, AR follow-up, correspondence and denial management and payer systems. • Familiarity with RCM software platforms (e.g., Nextgen, EPM, Athenahealth, Meditech). • Proficiency with project management tools (e.g., MS Project, JIRA). • Excellent written and verbal communication skills. Preferred Requirements • PMP® Certification from PMI or equivalent. • Experience in managing enterprise-wide RCM transformations. • Agile/Scrum certification preferred (PMI-ACP, SAFe, etc.)
