Senior Manager - Accounts Resolution

Key Responsibilities

1. Accounts Receivable & Denial Management

• Lead end-to-end Accounts Resolution operations, including AR follow-up, denial management, underpayment analysis, and payment recovery.
• Drive timely resolution of outstanding claims and reduce aged AR, including high-value and complex accounts.
• Identify recurring denial trends, root causes, and process gaps; implement corrective and preventive actions.
• Ensure appropriate prioritization of accounts based on ageing, claim value, payer requirements, and timely filing limits.
• Improve first-pass resolution, collection performance, and overall revenue realization.

2. Operational Excellence & Performance Management

• Define and monitor KPIs, including productivity, quality, collections, denial rates, AR ageing, and SLA adherence.
• Develop and execute action plans to achieve operational targets and contractual commitments.
• Drive continuous improvement initiatives, automation, and process standardization.
• Review operational dashboards and provide periodic performance updates to leadership and clients.
• Ensure adherence to client-specific requirements, internal policies, and compliance standards.

3. Leadership & People Management

• Lead and develop a large team of managers, team leaders, and AR specialists.
• Establish clear performance expectations and conduct regular business reviews.
• Identify training needs and build capabilities in payer follow-up, denial resolution, and analytical problem-solving.
• Drive employee engagement, talent development, succession planning, and retention.
• Build a culture of accountability, collaboration, and continuous improvement.

4. Client & Stakeholder Management

• Manage client relationships and participate in operational reviews, governance meetings, and escalation discussions.
• Present performance trends, recovery opportunities, risks, and improvement plans to clients and senior leadership.
• Partner with coding, billing, cash posting, and other RCM teams to resolve upstream and downstream issues.
• Ensure timely resolution of client escalations and maintain high client satisfaction.

5. Analytics, Reporting & Process Improvement

• Analyze AR ageing, payer-wise performance, denial patterns, collection trends, and revenue leakage.
• Use data-driven insights to identify opportunities for improved recovery and operational efficiency.
• Implement structured action plans for aged accounts, high-dollar claims, and underperforming payer segments.
• Support technology adoption, workflow automation, and reporting enhancements.

6. Compliance & Risk Management

• Ensure compliance with applicable US healthcare regulations, payer guidelines, HIPAA requirements, and client policies.
• Maintain process documentation, audit readiness, and appropriate controls for operational activities.
• Identify operational risks and implement mitigation plans to minimize revenue loss and compliance exposure.

Required Qualifications

• Bachelor's degree in Business Administration, Commerce, Healthcare Management, or a related discipline.
• Relevant experience in US Healthcare RCM, specifically Accounts Receivable and Accounts Resolution.
• Demonstrated experience managing large-scale AR operations and multiple teams.
• Strong knowledge of US healthcare payer processes, claim adjudication, denials, appeals, and reimbursement workflows.

Preferred Experience

• Experience handling complex AR portfolios, high-value claims, and multiple payer segments.
• Exposure to client-facing operations, transition management, process transformation, and automation initiatives.
• Experience managing operational budgets, workforce planning, and productivity improvement programs.