General Manager - Revenue Cycle Management, Process Control & Insurance/TPA

JOB DESCRIPTION Designation General Manager Revenue Cycle Management, Process Control & Insurance/TPA Liaison Grade AGM Location Corporate Office (with travel across hospital units) Department Revenue Cycle Management / Commercial Reporting To Chief Commercial Officer Qualification Graduate/Postgraduate in Healthcare Management, Finance, Commerce or Business Administration (MBA/MHA preferred) Qualified Experience 1215 years of progressive experience in Revenue Cycle Management, healthcare finance, or insurance/TPA liaison, with a significant part in a tertiary/quaternary care hospital or health insurance/TPA organization Main Objective of the Role To lead end-to-end revenue cycle management, institute robust process controls, drive strategic marketing and business development, and manage insurance/TPA relationships maximizing revenue realization, minimizing leakage, and enhancing the patient and payer experience across the hospital group. Key Responsibilities Revenue Cycle Management - Own end-to-end revenue cycle management for all insurance, TPA, and corporate patients across the hospital group. - Monitor and control Days Sales Outstanding (DSO), revenue leakage and denial rates. - Track and improve collection efficiency, receivables ageing and bad debt provisioning across all units. - Drive revenue assurance through periodic audits of billing accuracy, coding and tariff application. Insurance & TPA Liaison - Build and manage strategic relationships with insurance companies, TPAs and corporate clients to enhance empanelment, tariffs and payment terms. - Negotiate and renew MoUs/contracts with insurers, TPAs and corporates to secure favorable commercial terms. - Resolve escalated claim disputes, denials and delayed settlements in coordination with the claims and TPA teams. - Monitor TPA/insurer performance turnaround time, denial rates, settlement ratio and drive corrective engagement. Marketing & Business Development - Develop and execute marketing strategies to drive patient volumes, brand visibility and referral network growth. - Identify new business opportunities, including corporate tie-ups, health-check packages and new insurance/TPA empanelments. - Collaborate with market aggregators and third party patient financing for business proposition and promotional activities. - Track marketing ROI, patient acquisition metrics and campaign effectiveness. MIS, Reporting & Stakeholder Management - Prepare and present dashboards on revenue cycle performance, ageing, denials, TPA/insurer performance and marketing effectiveness to leadership. - Lead, train and mentor RCM, billing and liaison teams across locations. Collaborate closely with Finance, Billing, Clinical and Operations teams to ensure smooth cash flow and patient experience. - MIS Reports - Revenue Cycle Performance Dashboard - Receivables Ageing Report - Denial & Short-Payment Analysis Report - TPA/Insurer Performance Report - Collection Efficiency Report - Claims Settlement Tracker - Compliance & Process Audit Scorecard - Marketing ROI & Patient Acquisition Report New Empanelment / Contract Status Report - Supplementary Position Guidelines Key Relationships External: Insurance companies, TPAs, Corporates, Marketing/branding agencies, Regulatory bodies Please Note Job description is only a general guideline and will change depending on the organizational requirement. .