VP - RCM Operations

Vice President – Operations (Revenue Cycle Management) – Pune

Role Summary

The VP – Operations will lead end-to-end RCM operations for US healthcare clients from the Pune delivery center, overseeing billing, coding, AR follow-up, denial management, payment posting, and customer/client support. This leader will drive operational excellence, P&L ownership, quality/compliance, team productivity, and client satisfaction while building scalable processes and capabilities for growth.

Key Responsibilitie

sOperational Leadershi

• pOwn end-to-end RCM operations across the revenue cycle: patient access, prior authorization, coding, charge capture, billing, A/R follow-up, denial management, payment posting, and write-offs
• .Develop and execute the operations strategy for the Pune site, aligned with client SLAs and business goals
• .Ensure smooth coordination across functions (coding, billing, AR, denials, QA, training, and support) to optimize revenue and reduce leakages
• .Design and implement robust SOPs, workflows, and escalation matrices; continuously improve processes for efficiency and quality

.
Performance & KP

• IsDefine, monitor, and improve key RCM KPIs such a
• s:Days in A/R, DSO, clean claim rate, denial rate, first-pass yie
• ldCash collections, A/R aging, old A/R reducti
• onProductivity, quality accuracy, TAT, and SLA adheren
• ceBuild dashboards and reporting cadence for executive visibility and client reportin

g.
AR & Denial Managem

• entLead AR follow-up strategies across commercial/Medicare/Medicaid paye
• rs.Drive denial prevention and resolution programs, root cause analysis, and corrective action pla
• ns.Partner with coding, clinical, and billing teams to resolve medical necessity, coding, and documentation-related denia

ls.
Client & Stakeholder Manage

• mentServe as a key point of contact for client leadership; manage regular business reviews (QBRs/MB
• Rs).Build strong relationships with providers, payers (as applicable), and internal stakehold
• ers.Lead transition/onboarding of new accounts and ensure smooth handover into BAU operati

ons.
People Leadership & Capability Bui

• ldingLead and mentor operations managers, supervisors, team leaders, and functional leads across coding, billing, AR, and den
• ials.Build a high-performance culture with clear accountability, KPIs, and development p
• aths.Drive training programs on RCM workflows, SOPs, compliance, and leadership capabili

ties.
Compliance, Risk & Q

• ualityEnsure adherence to CMS, OIG, HIPAA, and payer-specific regulations across all RCM func
• tions.Partner with Compliance and QA to manage audits, corrective action plans, and payer escala
• tions.Implement internal controls around coding accuracy, claim submission, and documentation stan

dards.
Financial & P&L Ow

• nershipOwn P&L for the Pune site/vertical where applicable, including revenue, margin, utilization, and cost optimi
• zation.Drive productivity improvements, resource optimization, and technology-enabled automation to improve unit eco

nomics.
Required Ex

• perience15+ years of progressive experience in healthcare RCM, with at least 5–7 years in senior leadership (VP/Director/Sr. AVP
• ) roles.Proven track record managing large, multi-functional RCM operations (voice + non-voice), including coding, billing, AR, and
• denials.Experience managing a delivery center/operations hub in India (Pune preferred) serving US healthcare
• clients.Deep understanding of US healthcare payers, coding systems (ICD-10, CPT, HCPCS), and denial ar

vlevers.
Requir

• ed SkillsStrong operational leadership with ability to scale teams and p
• rocesses.Strong financial acumen and ability to link RCM performance to business
• outcomes.Excellent client-facing and executive communicatio
• n skills.Data-driven mindset with strong analytical, problem-solving, and change managemen
• t skills.Hands-on capability to dive into claims, denials, authorizations, and coding issues whe

n needed.
Preferred Qual

• ificationsBachelor's degree in Healthcare Administration, Business, Finance, or related field; Master's
• preferred.Knowledge of PM/EHR systems (e.g., Epic, NextGen, Athena, eCW) and
• RCM tools.Experience in a BPO/ITeS/RCM outsourcing environment is highly
• desirable.Six Sigma, Lean, or other process improvement certifications