Revenue Cycle Management, Manager

Adaptive Innovations•Houston, TX

About The Position

The Revenue Cycle Management (RCM) Manager leads and supports specialists handling home health revenue cycle workflows, with a focus on accounts receivable and moving outstanding claims from follow-up to verified resolution. The role stays close to daily operations, monitors team performance and workflow activity, answers questions, and helps the team meet its goals. The manager guides AR and collections work across commercial, Medicare, and Medicare Advantage receivables. This includes overseeing claim follow-up, investigating denials and collection barriers, ensuring accurate documentation, handling escalations, coordinating with partner teams, and reviewing proposed write-offs. The manager also supports quality assurance, coaching, onboarding, cross-training, process improvement, and feedback on dashboards and automation.

Requirements

Strong experience in home health revenue cycle operations.
Familiarity with Homecare Homebase (HCHB).
Experience managing RCM specialists, including tracking attendance and performance KPIs.
Experience monitoring workflows throughout the day and identifying risks to daily productivity targets.
Experience identifying collection challenges and implementing processes to resolve them.
Working knowledge of AR follow-up, denial investigation, appeals or reprocessing, and payer-specific filing requirements.
Experience reviewing claim documentation and quality, escalating unresolved issues, and coordinating with billing or posting teams.
Ability to respond promptly to team questions while managing multiple priorities.
Ability to identify workflow or process gaps and help the team address them.

Nice To Haves

Experience managing distributed or offshore revenue cycle teams.
Familiarity with commercial fee-for-service and Medicare or Medicare Advantage home health claims, including episodic/PDGM workflows.
Experience with AR dashboards, clearinghouses, and payer portals such as Waystar and Availity.
Experience using denial trends, quality reviews, or operational data to improve collections workflows and team training.

Responsibilities

Manage and support RCM specialists working across home health revenue cycle workflows.
Track attendance and monitor individual and team performance against established KPIs and daily quotas.
Review workflow boards throughout the day to identify backlogs, red flags, and specialists at risk of missing end-of-day quotas.
Respond promptly to specialist questions while balancing workflow monitoring and other team needs.
Identify process gaps and work with the team to resolve issues affecting daily performance.
Use home health and Homecare Homebase (HCHB) knowledge to help specialists navigate workflows and resolve operational questions.
Guide specialists and team leads in prioritizing commercial, Medicare, and Medicare Advantage receivables, including aged balances, payer responses, rejections, denials, and filing or appeal deadlines.
Oversee claim follow-up through resolution, including verifying claim status and payment, investigating collection barriers and underpayments, and guiding corrections, reprocessing, reconsiderations, or appeals under payer-specific requirements.
Review escalations when specialists cannot determine the next action; surface recurring payer, workflow, or system issues to leadership and coordinate resolution.
Ensure claim activity, supporting evidence, next actions, and follow-up dates are accurately documented in the applicable AR workflow and HCHB.
Partner with billing, payment posting, prior authorization, clinical, and other teams to resolve discrepancies, obtain documentation, and follow paid-but-not-posted claims through resolution.
Review proposed write-offs for documented collection efforts and supporting evidence, and route them through the required approval and posting process.
Review claim work for accurate denial interpretation, appropriate action, complete documentation, timely follow-up, and correct escalation; use findings to coach specialists and strengthen performance.
Support onboarding, payer and system cross-training, and regular knowledge sharing.
Identify patterns behind collection challenges and update SOPs or workflows to prevent repeat issues.
Share frontline feedback on AR dashboards and automation with relevant teams to improve prioritization, visibility, and specialist workflows.