RCM Manager
About The Position
The Operational RCM Manager is responsible for overseeing the daily operations of the Revenue Cycle Management (RCM) department, ensuring accurate, efficient, and compliant processing of all revenue cycle functions. This role manages functional teams—including Charge Entry, Payment Posting, Billing, Denial Management, and AR follow-up—and drives performance, quality, and process improvement. The Operational RCM Manager provides leadership, training, and strategic direction to staff while partnering with clinical, administrative, and billing stakeholders to optimize financial outcomes and enhance the patient experience.
Requirements
- Bachelor’s degree in healthcare administration, business, or related field (or equivalent experience).
- 3–5+ years of experience in Revenue Cycle Management operations.
- 2+ years of supervisory or management experience.
- Strong knowledge of medical billing, coding concepts, payer reimbursement methodologies, and denial resolution.
- Proficiency with EHR/Practice Management systems and reporting tools.
Nice To Haves
- Experience in specialty practice RCM (e.g., surgical, oncology, primary care, etc.).
- Certification such as CRCR, CPC, CPB, or HFMA credential.
- Experience leading teams through operational or structural transitions.
Responsibilities
- Manage end-to-end revenue cycle operations, including registration quality, charge entry, coding oversight, payment posting, insurance billing, denials, and collection activities.
- Supervise functional team leads and staff members; assign workloads, evaluate performance, and ensure accountability for KPIs.
- Maintain operational dashboards to monitor productivity, aging, quality, and revenue leakage.
- Develop, refine, and implement standardized workflows and SOPs across all RCM functions.
- Identify bottlenecks and inefficiencies; implement improvements using Lean, Six Sigma, or other process methodologies.
- Ensure accuracy of claim submissions, payment posting, adjustments, and denial categorizations.
- Ensure all processes comply with payer rules, state/federal billing regulations, and internal compliance standards.
- Audit work output for accuracy, timely completion, and quality.
- Collaborate with compliance and coding teams to resolve documentation, coding, or regulatory discrepancies.
- Develop and maintain RCM KPIs, including clean-claim rate, denial rate, days in AR, charge lag, collection rate, and productivity metrics.
- Prepare weekly/monthly performance reports for leadership.
- Provide coaching and corrective action plans where necessary.
- Act as the primary liaison between clinical operations, billing teams, IT, finance, and external partners.
- Participate in cross-functional meetings to address root causes of denials, documentation issues, and workflow challenges.
- Communicate updates, process changes, and training needs to internal stakeholders.
- Oversee use of practice management, EHR, clearinghouse, and analytics platforms.
- Partner with IT to optimize system configuration and user access roles.
- Support system upgrades, project rollouts, and staff onboarding/training.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
