Corp Managed Svcs RCMS - Hospital Billing AR Calling - Sr Associate - Operate

At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs, develop operational strategies, and offer guidance and support to help clients streamline processes, improve productivity, and drive business performance. In operations and solutions at PwC, you will focus on providing consulting services to optimise overall operational performance and develop innovative solutions. You will work closely with clients to analyse operational processes, identify areas for improvement, and develop strategies to enhance productivity, quality, and efficiency. Working in this area, you will provide guidance on implementing technology solutions, process automation, and operational excellence frameworks.

Focused on relationships, you are building meaningful client connections, and learning how to manage and inspire others. Navigating increasingly complex situations, you are growing your personal brand, deepening technical expertise and awareness of your strengths. You are expected to anticipate the needs of your teams and clients, and to deliver quality. Embracing increased ambiguity, you are comfortable when the path forward isn’t clear, you ask questions, and you use these moments as opportunities to grow.

Skills

Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to:

• Respond effectively to the diverse perspectives, needs, and feelings of others.
• Use a broad range of tools, methodologies and techniques to generate new ideas and solve problems.
• Use critical thinking to break down complex concepts.
• Understand the broader objectives of your project or role and how your work fits into the overall strategy.
• Develop a deeper understanding of the business context and how it is changing.
• Use reflection to develop self awareness, enhance strengths and address development areas.
• Interpret data to inform insights and recommendations.
• Uphold and reinforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance), the Firms code of conduct, and independence requirements.
  
  

JD Template -Corp Managed Svcs RCMS- Senior Associate - Operate

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Job Summary -

A career in our Managed Services team will give you an opportunity to collaborate with many teams to help our clients implement and operate new capabilities, achieve operational efficiencies, and harness the power of technology. Our Revenue Cycle Managed Services team will provide you with the opportunity to act as an extension of our healthcare clients revenue cycle functions. We specialize in front, middle and back-office revenue cycle functions for hospitals, medical groups, and other providers. We leverage our custom and automated workflow and quality assurance products to enable our clients

to achieve better results, which ultimately allows them to provide better patient care.

Minimum Degree Required (BQ) *:

Bachelors degree

Degree Preferred

Required Field(s) of Study (BQ):

Computer Science, Data Analytics, Accounting

Preferred Field(s) Of Study

Minimum Year(s) of Experience (BQ) *: US

3 years of experience

Certification(s) Preferred

Preferred Knowledge/Skills *:

• Preferred Qualification: Bachelor’s degree in finance or Any Graduate
• 4-8 years of experience in healthcare revenue cycle management, with a focus on accounts receivable and team leadership.
• Strong understanding of medical billing processes, insurance claims management, and revenue cycle operations.
• Excellent communication skills and ability to interact effectively with internal stakeholders, insurance companies, and patients.
• Proficiency in healthcare billing software and Microsoft Office applications.
• Proven leadership abilities with a track record of successfully managing and developing teams.
• Detail-oriented with strong analytical and problem-solving skills.
• Knowledge of regulatory requirements and compliance in healthcare revenue cycle management.
• Shift timings: Flexible to work in night shifts (US Time zone)
  
  

Team Management And Leadership

Supervise a team of AR callers, providing guidance, support, and mentorship to achieve departmental goals. Conduct regular team meetings, one-on-one sessions, and performance evaluations to drive accountability and continuous improvement. Foster a positive and collaborative work environment that encourages teamwork and professional development.

Accounts Receivable Oversight

Oversee the accounts receivable process, including insurance claims follow-up and patient account resolution. Monitor productivity and efficiency metrics (e.g., call volume, claim resolution rate) and implement strategies to optimize team performance. Ensure adherence to departmental policies, procedures, and quality standards.

Insurance And Payer Relations

Handle escalated insurance claim issues and complex payer inquiries, providing expertise and assistance to team members. Develop and maintain relationships with insurance company representatives to expedite claim processing and resolve payment delays. Stay informed about changes in insurance policies, billing guidelines, and reimbursement regulations.

Process Improvement And Training

Identify opportunities for process enhancements and workflow optimization within the AR calling function. Develop and deliver training programs to equip team members with the skills and knowledge necessary to excel in their roles. Implement best practices and standard operating procedures to drive operational efficiency and quality outcomes.

Reporting And Analysis

Generate regular reports on team performance metrics, KPIs, and key trends in accounts receivable. Analyze data to identify areas of improvement, implement corrective actions, and track progress towards goals.

PMS Experience

• Epic HB & PB experience is Mandatory

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