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Company Description
Gulf Coast RCM and Billing Solutions is a high-growth startup on a mission and we are on a mission to redefine "Concierge-Level" high-performance RCM and clinical solutions. We help specialized medical practices across the US build elite remote teams for Scribing, Coding, Billing, and Front-Office operations.
Our mission is centered on our Clients, our People, and Operational Excellence, ensuring that every interaction adds value to the healthcare ecosystem.
Distinguished by our pursuit of "Concierge-Level" standards, Gulf Coast excels in:
- Scale-Up Culture: We are a lean, agile startup looking to scale rapidly. You won’t just be a number here; you will be a foundational member of our core team.
- Expert Recruitment: We selectively hire only the top industry professionals; established experts who are already HIPAA-certified and highly experienced.
- Peak Performance: We provide an environment built for elite talent to excel. We don't do basic training; we focus on high-level execution and operational precision.
- Secure Infrastructure: We provide a premium, high-security workspace equipped with cutting-edge technology and a professional corporate culture.
If you are a professional who thrives in a fast-paced, high-standard environment, we want to build the future of RCM with you.
Role Description
We are looking for a high-caliber Senior Operations Manager to lead our new boutique RCM center in Hyderabad. You will be responsible for the end-to-end performance of a specialized team supporting US-based physicians. Your mission is to ensure "Concierge-Level" service, maintaining a Net Collection Rate >96% and a Denial Rate <5%. You will serve as the primary bridge between the Hyderabad production team and the US leadership.
Key Responsibilities
- Operational Leadership: Oversee daily activities across Front-End (Eligibility/Auth), Mid-Cycle (Virtual Scribing), and Back-End (Coding/Billing/AR) teams.
- Quality Assurance: Conduct 100% manual audits on claims and charts during the first 30 days; transition to high-frequency spot checks to ensure zero-backlog.
- Client Success: Lead the "Daily Huddle" with US physician leads to discuss blockers, high-value denials, and process improvements.
- KPI Management: Own and report on critical metrics: First-Pass Clean Claim Rate, Days in A/R, and Chart Closure Turnaround Time.
- Team Coaching: Utilize Whisper/Barge technology to coach agents in real-time, specifically focusing on accent neutralization and negotiation with US payers.
- Compliance Officer: Ensure strict adherence to HIPAA and ISO 27001 standards, maintaining a "Clean Desk Policy" and secure VDI protocols.
Required Qualifications
- Experience: Minimum 10-12 years in US RCM, with at least 5 years in a leadership/Associate Director role.
- Technical Expertise: Expert-level knowledge of Medical Coding (CPT/ICD-10) and the US insurance landscape (Medicare, Commercial, PPO/HMO).
- Software: Proficiency in top-tier EHRs and Clearinghouses (e.g., Availity, Waystar, AthenaOne).
- Communication: Exceptional verbal and written English; ability to confidently manage expectations of US-based MDs.
- Strategic Thinking: Ability to build SOPs from scratch and scale the team as more physicians are onboarded.
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