RCM Team Lead - Process Excellence

Allscripts — Pune, India

Key Responsibilities 1. SOP Development & Governance Draft, author, and publish SOPs for all RCM functions: Charge Entry, Claims Processing, Payment Posting, AR Follow-Up, and Denial Management Conduct periodic SOP reviews (quarterly or upon policy/payer/client changes) and maintain strict version control Maintain and govern a centralized SOP repository accessible to operations and quality teams Facilitate SOP awareness and walkthrough sessions with floor teams and managers to ensure adoption Track SOP compliance through audits and flag deviations to operations leadership 2. Process Mapping & Workflow Create detailed swim lane flowcharts, process maps, and decision-tree diagrams for all RCM sub-processes Document current-state ('As-Is') and future-state ('To-Be') workflows Identify bottlenecks, handoff gaps, redundancies, and failure points within existing workflows Maintain a structured process library with all maps versioned and linked to corresponding SOPs Produce workflow visuals for leadership presentations, client onboarding packs, and audit readiness reviews 3. Automation Collaboration & BRD Drafting Collaborate with the RPA/automation team to translate manual RCM tasks into Business Requirement Documents (BRDs) Draft rule-based logic documents for bot development covering tasks such as claim status checks, ERA/EOB posting, denial categorization, and eligibility verification Maintain an automation opportunity pipeline by identifying high-volume, rule-based, repetitive tasks across LOBs Support UAT (User Acceptance Testing) for automation deployments and provide operational sign-off from a process perspective Act as the process SME during bot design discussions, ensuring automation logic aligns with real-world operational workflows 4. Operational Standardization & Floor Support Partner with operations managers and teams leads to embed standard processes into day-to-day workflows Support new client onboarding by developing client-specific SOPs and customized pr

View on HireSetu