Senior Manager / Director Operations
6 days ago
Richardson
Job Description Position Summary The Operations Manager (RCM) is responsible for leading end-to-end revenue cycle operations with a strong focus on billing, prior authorization, denials, and appeals management. This role ensures operational performance, regulatory compliance, and delivery against client and organizational objectives. The Operations Manager oversees large-scale teams, manages inventory and workflow, and implements strategies to improve collections, reduce denials, and optimize revenue outcomes. This position requires a deep understanding of billing systems, payer requirements, and denial management processes, while driving cross-functional collaboration and continuous improvement. Performs other duties as assigned. Job Roles & Responsibilities • Lead and oversee daily operations across billing, eligibility, prior authorization, denials, appeals, AR follow-up, and payment posting functions, • Manage and develop large teams (100+ FTEs), including direct supervision, coaching, performance management, and employee development, • Direct denials management operations, including research, appeals, reimbursement analysis, and follow-up on pending claims, • Ensure timely, accurate submission of claims and resolution of accounts to maximize reimbursement and minimize denials, • Analyze reimbursement trends, payer behavior, and denial patterns to drive corrective actions and improve outcomes, • Oversee inventory management, workload distribution, and prioritization to ensure timely execution and reduce aging risk, • Collaborate with cross-functional teams (HR, IT, Compliance, Quality, Training) to support operational initiatives and process improvements, • Act as a liaison across departments to ensure alignment, communication, and execution of revenue cycle initiatives, • Monitor adherence to policies, procedures, and compliance requirements, including auditing and quality assurance activities, • Provide reporting and insights to leadership and clients, including operational performance, KPIs, and improvement plans, • Lead Monthly Business Reviews (MBRs) and support client-facing discussions, • Support hiring, onboarding, training, and ongoing development of team members, • Foster a high-performance culture focused on accountability, engagement, and retention, • Ensure proper payer setup, eligibility validation, and billing system accuracy, • Maintain confidentiality and ensure proper handling of Protected Health Information (PHI) Qualifications & Requirements Experience & Education • Bachelor’s degree required (or equivalent experience), • 8+ years of experience in end-to-end Revenue Cycle Management (RCM), • Minimum 3+ years of leadership experience in a high-volume billing or denials management environment, • Experience managing large teams in fast-paced operations, • Laboratory billing & Patient Collections experience preferred Technical & Functional Expertise • Strong knowledge of reimbursement, billing, coding, and healthcare compliance regulations, • Deep understanding of payer eligibility, benefits, and denial management processes, • Experience with billing systems and revenue cycle platforms, • Proficiency in Microsoft Office Suite, particularly Excel and PowerPoint, • Ability to perform complex data analysis and present findings to leadership Leadership & Behavioral Competencies • Strong leadership and team management skills with the ability to drive performance and accountability, • Excellent communication, presentation, and stakeholder management abilities, • Strong analytical, problem-solving, and decision-making skills, • Ability to manage multiple priorities, projects, and workflows simultaneously, • Strong organizational skills and attention to detail, • Ability to collaborate effectively across all levels of the organization, • Demonstrated ability to resolve employee and operational issues efficiently, • Adaptability and ability to operate in a fast-paced, evolving environment, • Commitment to high standards of customer service and operational excellence Performance Expectations • Deliver consistent operational performance aligned to KPIs & client expectations, • Proactively identify and resolve operational risks, bottlenecks, and inefficiencies, • Maintain strong ownership of assigned portfolios with measurable improvements in performance, • Provide clear visibility into performance, risks, and action plans Healthcare providers serviced by CGS include medical transport providers, emergency physicians, health infusion service providers and diagnostic laboratories. In the telecommunication vertical, CGS serves four of the top five providers in United States. Credence Resource Management is the flagship company of the Credence Group. Our mantra is Excellence Beyond Belief. Challenges, growth opportunities and a passion for the Job enables us to repeatedly deliver excellence to our clients. Our teams are encouraged to continually explore their talents and pursue their interests, giving them the authority to gain knowledge and skills to truly be the expert in their domain. We strive to bring on the best and brightest, as well as to invest in their training and education, making them a seamless extension of your team. Headquartered in Dallas TX, we have delivery offices in San Jose CA; Natchez MS; Mesa AZ & Pune India. Visit to know more about the company.Credence Global Solutions (“CGS”) is a Dallas, Texas based diversified technology driven financial transformation company with deep expertise in receivables management and voice based BPO. With focus on Receivables Management, Healthcare RCM, Technology Platforms and Contact Center verticals, CGS services leading telecommunication, healthcare, and media companies.\r\n\r\nHealthcare providers serviced by CGS include medical transport providers, emergency physicians, health infusion service providers and diagnostic laboratories. In the telecommunication vertical, CGS serves four of the top five providers in United States.\r\n\r\nCredence Resource Management is the flagship company of the Credence Group.\r\n\r\nOur mantra is Excellence Beyond Belief. Challenges, growth opportunities and a passion for the Job enables us to repeatedly deliver excellence to our clients. Our teams are encouraged to continually explore their talents and pursue their interests, giving them the authority to gain knowledge and skills to truly be the expert in their domain. We strive to bring on the best and brightest, as well as to invest in their training and education, making them a seamless extension of your team.\r\n\r\nHeadquartered in Dallas TX, we have delivery offices in San Jose CA; Natchez MS; Mesa AZ & Pune India. Visit to know more about the company.