Operations Manager - RCM - Credense Medical Billing Pvt. Ltd. - Hyderābād, India
(2026-03)
- Manage end-to-end US Healthcare RCM operations across multiple clients/accounts.
- Oversee Billing, Claims Submission, Payment Posting, AR Follow-up, Denial Management, Patient Helpdesk, and Credentialing teams.
- Ensure achievement of operational KPIs including productivity, quality, turnaround time (TAT), SLA adherence, and revenue targets.
- Present operational and financial performance reports to senior leadership.
- Conduct business reviews with clients and present performance metrics and ensure high client satisfaction through proactive communication and service delivery.
- Serve as the primary escalation point for client operational issues and collaborate with clients to implement process improvements.
Senior Manager - Quality Control and L&D - Founders (ThinkFounders Advisors Pvt. Ltd) - Bangalore, India
(2023-05 - 2024-10)
- Led Quality Control and Learning & Development functions across end-to-end RCM operations, driving audit governance, compliance adherence (HIPAA), and continuous capability enhancement to improve FPR, accuracy, and revenue outcomes.
- Standardize audit processes across multiple business units and clients and lead quality governance meetings and business reviews.
- Designed and executed strategic training, quality frameworks, and performance improvement initiatives aligned with operational KPIs, cost optimization goals, and organizational growth objectives.
- Measure training effectiveness using pre/post assessments, quality improvements, productivity gains, and business KPIs. Build competency frameworks and career development pathways.
- Develop and maintain SOPs, process documentation, and operational controls. Coordinate internal and external compliance
Manager - RCM - AdvantEdge Healthcare Solutions Pvt. Ltd. (Health Prime) - Bangalore & Mumbai, India
(2015-08 - 2023-05)
- Drove KPI-based performance, governed HIPAA compliance, managed team productivity, and implemented process improvements to enhance First Pass Resolution (FPR) and overall revenue realization.
- Oversaw end-to-end RCM Operations, Business Excellence, and QC encompassing billing, AR, denial management, and reimbursement optimization to improve cash flow and reduce AR aging.
- Led Business Excellence team with collaboration of operations, coding, billing, and quality teams to drive process optimization, implement data-driven improvements, and streamline workflows.
- Oversaw audit reviews, performance coaching, and process standardization to enhance team productivity, reduce denials, and ensure HIPAA-compliant billing practices.
- Managed and maintained quality performance dashboards, ensuring accurate KPI tracking, real-time reporting visibility, and data-driven decision support for leadership.
- Designed and executed end-to-end leadership development programs—from curriculum design and content creation to facilitation and effectiveness measurement—driving measurable capability growth and organizational performance improvement.
- Administered end-to-end process training for Revenue Cycle Management (RCM) teams, designing and delivering curriculum on medical billing, AR follow-up, denial management, and payer guidelines to ensure operational readiness.
- Monitored training effectiveness through assessments, quality metrics, and performance feedback, driving improved throughput %, productivity, quality and compliance adherence.
- Designed and delivered process-driven training programs on RCM workflows, medical billing, AR follow-up, and compliance standards (HIPAA), ensuring improved accuracy and productivity.
- Conducted training needs analysis, monitored post-training performance metrics, and collaborated with operations and quality teams to enhance competency, reduce denials, and strengthen revenue outcomes.
- Delivered structured training programs on end-to-end RCM, including AR follow-up, denial management and billing operations.
- Supported onboarding, conducted knowledge assessments, and tracked training effectiveness to accelerate team performance readiness.
Sr. AR Analyst - Operations - AdvantEdge Healthcare Solutions Pvt. Ltd. - Bangalore, India
(2015-05 - 2015-07)
- Performed Accounts Receivable (AR) follow-up, including tracking outstanding claims, resolving denials, managing underpayments, and reducing aging buckets (30/60/90+ days).
Sr. Executive - Operations - Hinduja Global Solutions Ltd. - Bengaluru, KA
(2012-08 - 2015-04)
- Served as primary point of contact for patients and insurance payers, handling billing inquiries, payment arrangements, and claim-related concerns within the Revenue Cycle Management (RCM) framework.
- Processed patient payments, credit card transactions, and payment postings in compliance with HIPAA guidelines and healthcare data privacy regulations.
