Highly accomplished and results-oriented Revenue Cycle Management (RCM) leader with 11+ years of comprehensive experience spanning front-end operations, end-to-end RCM, quality assurance, training, and large-scale team management within the US healthcare sector. Proven ability to drive significant improvements in key RCM KPIs, enhance client satisfaction, optimize workflows, and lead cross-functional teams to achieve operational excellence. Seeking to leverage expertise in client relationship management, data-driven analysis, process improvement, and team leadership to excel as an RCM Service Manager, contributing to enhanced client performance and satisfaction.
Hi, I’m
Vivek Kumar
Assistant Operations Manager
New Delhi,DL
Summary
Timeline
Assistant Operations Manager
R1 RCM Global Pvt Ltd
05.2023 - Current
Team Leader
EyeCareLeaders Pvt Ltd
07.2017 - 05.2023
Senior Quality Assurance Auditor
EyeCareLeaders Pvt Ltd
01.2017 - 06.2017
Quality Auditor
R1 RCM Global Pvt Ltd
05.2015 - 12.2016
Process Trainer
R1 RCM Global Pvt Ltd
06.2014 - 05.2015
AR Analyst
R1 RCM Global Pvt Ltd
09.2013 - 06.2014
University of Delhi
Bachelor of Science from Chemistry
08.2010 - 07.2013
CBSE
High School Diploma
04.1997 - 06.2010
Work History
R1 RCM Global Pvt Ltd
Assistant Operations Manager
05.2023 - Current
Job overview
- Lead and manage a large-scale team, handling front-end RCM operations for multiple US healthcare provider accounts.
- Develop, implement, and monitor KPI dashboards (tracking productivity, quality, inventory) to measure team performance and overall process health against client SLAs.
- Oversee daily operations, ensuring timely and accurate claims processing, adherence to client-specific protocols, and achievement of revenue cycle targets.
- Act as a key point of contact for client communication, managing escalations, addressing concerns regarding practice performance, and presenting weekly/monthly performance reviews to clients and executive leadership, fostering strong, long-term partnerships.
- Partner effectively with cross-functional teams (Coding, Billing, IT, Automation) to streamline end-to-end workflows, identify and fix process gaps, reduce redundancies, and implement efficiency improvements.
- Ensure strict adherence to HIPAA compliance and stay updated on evolving regulations.
- Conduct performance reviews, deliver targeted coaching and training to uplift team member skills, and implement strategies for FTE budgeting, allocation, shrinkage reduction, and attrition management.
- Facilitate calibration sessions with Quality & Training teams to align evaluation parameters and ensure consistent, accurate feedback.
EyeCareLeaders Pvt Ltd
Team Leader
07.2017 - 05.2023
Job overview
- Directed and mentored a team of 40+ associates, including 3 Subject Matter Experts (SMEs), across the full spectrum of RCM functions: Eligibility Verification, Billing, Rejection Handling, AR Denials Management, Credentialing, and Patient Collections.
- Managed end-to-end client relationships, including onboarding, EMR/PMS implementation support, and integration with clearinghouse technology for efficient claims submission and status monitoring.
- Served as the primary communication liaison for assigned clients, preparing performance dashboards, leading weekly/monthly review discussions, resolving escalations, and managing offshore-onshore coordination.
- Utilized data analytics to identify denial trends, providing proactive insights and strategic recommendations to clients that significantly improved first-pass resolution rates and reduced AR aging.
- Developed and standardized Standard Operating Procedures (SOPs) across various RCM functions, enhancing quality, consistency, and reducing errors.
- Collaborated closely with software development teams to provide feedback and drive improvements in proprietary RCM software, contributing to reduced denial rates.
- Focused on team development through coaching, feedback, bottom-quartile management, conflict resolution, and initiatives to reduce attrition and shrinkage while ensuring HIPAA compliance.
EyeCareLeaders Pvt Ltd
Senior Quality Assurance Auditor
01.2017 - 06.2017
Job overview
- Conducted comprehensive audits of RCM processes, systems, and operational outputs, evaluating adherence to internal controls, industry standards (including HIPAA), and client-specific requirements.
- Analyzed audit data and performance metrics to identify trends, process gaps, and areas for quality improvement, preparing detailed reports with findings and corrective action plans.
- Collaborated with operational teams to implement corrective actions and contributed to continuous improvement initiatives, ensuring consistent quality standards through calibration and training reinforcement.
R1 RCM Global Pvt Ltd
Quality Auditor
05.2015 - 12.2016
Job overview
- Performed regular quality audits on RCM processes, assessing compliance, identifying areas for improvement, and analyzing metrics to support operational enhancements.
- Prepared audit reports, communicated findings to relevant teams, and assisted in implementing corrective actions to ensure adherence to quality standards and protocols.
R1 RCM Global Pvt Ltd
Process Trainer
06.2014 - 05.2015
Job overview
- Designed, developed, and delivered comprehensive training programs focused on AR Denials Management, payer-specific guidelines, and RCM best practices for new hires and existing employees.
- Assessed training effectiveness, provided ongoing coaching and support, maintained updated training materials, and ensured alignment with HIPAA and compliance regulations.
R1 RCM Global Pvt Ltd
AR Analyst
09.2013 - 06.2014
Job overview
- Executed core AR follow-up activities, including contacting insurance carriers on unpaid/underpaid claims, resolving billing discrepancies, and analyzing aging reports to prioritize collections.
- Processed payments, reconciled remittances, and contributed to identifying process improvements within the AR cycle.
Overview
12
years of professional experience
16
years of post-secondary education
Skills
- Client Relationship Management & Communication
- Team Leadership & Development (Coaching, Mentoring, Performance Management)
- RCM Operations Management & Workflow Optimization
- Data Analysis & Performance Reporting (KPI Tracking)
- Strategic Planning & Process Improvement
- Problem-Solving & Conflict Resolution
- HIPAA Compliance & Payer Regulations Expertise
- Proficient with multiple EHR/PMS systems
- Expert in Microsoft Office
- Proficient in SQL for data extraction and reporting
- Familiarity with tools like Salesforce (CRM), Slack, Zoom, GSuite
Accomplishments
Accomplishments
- Successfully led initiatives resulting in the resolution of a $100M billing backlog through effective problem-solving and process optimization.
- Improved overall team productivity to 115% while maintaining a high accuracy rate of 98%.
- Contributed to the development and implementation of a proprietary one-stop RCM software solution, enhancing efficiency and reducing manual intervention.
- Received a client appreciation award recognizing outstanding collaboration, effective communication, and proactive problem-solving.
- Awarded a quality excellence award for implementing process improvements that significantly enhanced operational accuracy.
- Recognized as a "Star Performer" for consistently exceeding performance metrics and demonstrating exceptional leadership capabilities.
Education
University of DelhiNew Delhi
Bachelor of Science from Chemistry
08.2010 - 07.2013
University Overview
CBSENew Delhi
High School Diploma
04.1997 - 06.2010
University Overview
Work Preference
Work Type
Full TimeWork Location
On-SiteRemoteHybridLanguages
English
Bilingual or Proficient (C2)
Hindi
Bilingual or Proficient (C2)
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