RCM Manager

HEALTH CHOICE NETWORK

About The Position

As the RCM Manager, you will be a pivotal figure in overseeing and managing the entire revenue cycle, including billing, coding, collections, and denial management. You will serve as the primary point of contact for our customers, developing, evaluating, implementing, and revising policies and procedures to enhance our revenue cycle efficiency. You will also stay informed about reimbursement billing procedures and government regulations, ensuring compliance, and driving continuous improvement initiatives.

Requirements

Bachelor's degree in Healthcare Administration, Business, or a related field (preferred).
A minimum of 5 years of experience in revenue cycle management or a related field.
Profound understanding of billing, coding, and reimbursement processes.
Knowledge of third-party and private insurance payer regulations.
Experience working with Epic (Epic Resolute or other Epic revenue cycle modules preferred).
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).
Excellent communication and interpersonal skills.
Proficiency in data analysis and reporting.
Demonstrated ability to meet or exceed performance targets.
Effective problem-solving and decision-making skills.

Responsibilities

Customer Relationship: Act as the primary point of contact for our customers, addressing their inquiries and concerns.
Cultivate and maintain positive client relationships to ensure satisfaction and retention.
Conduct weekly, bi-weekly calls with the customer, which include an agenda of trends and opportunities to discuss.
Revenue Cycle Oversight: Manage and oversee the complete revenue cycle, encompassing billing, coding, collections, and denial management.
Ensure that revenue cycle activities are executed efficiently and in accordance with relevant regulations.
Support RCM Lead on management, development, and mentorship of revenue department staff, including billers and coders.
Policy and Procedure Development: Develop, evaluate, implement, and revise policies and procedures related to billing, coding, reimbursement activities, and improvement strategies.
Streamline processes and align them with best practices to enhance operational efficiency.
Regulatory Compliance: Stay updated on reimbursement billing procedures of third-party and private insurance payers as well as government regulations.
Guarantee compliance with all pertinent guidelines and standards.
Performance Metrics: Meet or exceed defined monthly Key Performance Indicators related to revenue cycle performance.
Continuously monitor and analyze performance data, identifying areas for improvement.
Provide monthly reports on Key Performance Indicators to stakeholders, summarizing changes and trends as defined by the department.
Issue Resolution: Manage and maintain an issue log, diligently working to resolve revenue cycle issues.
Collaborate with team members to address challenges and implement effective solutions.
Performance Review: Conduct regular reviews of weekly and monthly performance with the team lead, identifying strengths and opportunities for improvement.
Offer guidance and coaching to the team to enhance their performance while managing and executing any employee improvement plans in place.
Change Management: Lead the execution of change management initiatives and workflow enhancements within the revenue cycle department.
Ensure effective communication and implementation of changes, fostering a culture of adaptability.
Provide feedback and proposed changes to leadership team as opportunities arise, conducting a root-cause analysis when able in efforts to identify solutions.