Senior Manager - RCM Operations (Epic Resolute PB)

Job Summary:

We are looking for an experienced Senior Manager to lead Epic Resolute Professional Billing (PB) operations for US healthcare clients. The role involves managing end-to-end Provider RCM operations, improving productivity and quality, reducing claim denials, ensuring SLA compliance, and driving client satisfaction.

Key Responsibilities:

• Lead end-to-end Epic Resolute Professional Billing operations.
• Manage Charge Review, Claim Edits, AR, Denial Management, Credit Balances, and Payment Posting.
• Drive productivity, quality, SLA adherence, and revenue cycle performance.
• Monitor KPIs, identify process gaps, and implement continuous improvements.
• Lead and develop operational teams, including managers and team leaders.
• Manage client relationships, operational reviews, and escalations.
• Ensure compliance with HIPAA requirements and client-specific policies.

Required Qualifications:

• Bachelor's degree in a relevant discipline; Master's degree preferred.
• 812 years of experience in US Healthcare RCM.
• Minimum 35 years of hands-on experience in Epic Resolute Professional Billing (PB).
• Proven experience managing end-to-end Provider RCM / Professional Billing operations.
• Strong knowledge of Charge Review, Claim Edits, AR, Denials, Credit Balances, and Payment Posting.
• Experience in team leadership, client management, SLA management, and process improvement.
• Good understanding of US healthcare claims, CPT, ICD-10-CM, and payer reimbursement processes.

Preferred Qualifications

• Epic Resolute Professional Billing certification.
• Experience managing offshore RCM operations.
• Lean Six Sigma certification or exposure to automation and analytics.

Interested candidates with strong Epic Resolute PB and US Provider RCM experience are encouraged to apply.