Gurugram, India
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Role: Revenue Cycle Management (RCM) Product Consulting
Position Summary: We are looking for a highly skilled professional to join as a Techno-Functional Expert in the field of RCM. This role will serve as a critical bridge between business stakeholders, domain experts, and technology teams and will contribute to the development of a next-generation RCM platform integrating outcome-driven automation and AI-powered capabilities, including but not limited to claims automation, autonomous coding, collections, analytics and denials management. The ideal candidate brings deep field-level knowledge of revenue cycle workflows and is adept at translating operational pain points into technical requirements for innovative, scalable solutions.
Key Responsibilities
Business Analysis & Requirements Gathering
• Engage with RCM stakeholders (operations, compliance, technology) to gather and document detailed business requirements across intake, coding, billing, claims, A/R, and denials.
• Define user stories, business rules, data flows, and system behavior aligned with operational outcomes.
• Work closely with product managers to prioritize features based on business value and technical feasibility.
• Partner with sales and account teams to shape solutions for new opportunities, contributing to solution design, proposals, due diligence, and client presentations.
Subject Matter Expertise (SME)
• Provide domain expertise in U.S. healthcare revenue cycle processes and technologies.
• Offer field-level insights from front-end intake through back-end collections and appeals.
• Advise on industry best practices, compliance considerations, and emerging trends in automation and AI adoption in RCM.
Techno-Functional Collaboration
• Act as a liaison between business users and development teams to ensure solution design aligns with functional needs.
• Partner with architects and engineers on data modeling, workflow engines, and AI/ML model integration.
• Participate in user acceptance testing (UAT), validating system outputs against business expectations.
Platform Innovation
• Contribute to platform design and modularization of features such as (but not limited to)
o Claims Automation (e.g., OCR, NLP, intelligent form capture)
o Autonomous Coding (ICD/CPT code prediction using AI/ML)
o Process Optimization (clearinghouse logic, eligibility validation)
o Denials Prevention & Prediction (ML-based denial scoring, root cause analytics)
• Identify opportunities for AI/automation to enhance accuracy, reduce TAT, and minimize human intervention.
• Documentation & Change Management
• Develop clear documentation including BRDs, FRDs, process maps, and data dictionaries.
• Support training, change management, and knowledge transfer to internal teams and client stakeholders.
Bachelor's, BCA
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services, Healthcare, Insurance, Shipping and Logistics, and Travel and Hospitality. We bring together deep domain excellence – WNS’ core differentiator – with AI-powered platforms and analytics to help businesses innovate, scale, adapt and build resilience in a world defined by disruption.Our purpose is clear: to enable lasting business value by designing intelligent, human-led solutions that deliver sustainable outcomes and a differentiated impact. With three global headquarters across four continents, operations in 13 countries, 65 delivery centers and more than 66,000 employees, WNS combines scale, expertise and execution to create meaningful, measurable impact.