Senior Manager, RCM

FULGENT THERAPEUTICS LLC•Coppell, TX

4d•Onsite

About The Position

The Senior Manager, Revenue Cycle Management manages team performance and policies for coding, data entry, billing, accounts receivable, and reimbursement. The role ensures current coding and payer information is maintained and distributed, and that changes support timely, accurate, and compliant claims filing and reimbursement. It also fosters collaboration among RCM vendors, sales, and clinical departments to improve efficiency and the patient experience. The position builds and oversees the RCM Integrity program from patient services through claims submission and collections, conducts risk assessments and audits, advises senior leadership on billing integrity and regulatory compliance, and implements approved process improvements. It serves as the primary liaison for escalated RCM issues; develops compliant policies, procedures, and workflows; administers payer portals and EDI connectivity; monitors reimbursement changes and data; and trains clinicians, sales, and billing staff. The role also plans, directs, and supervises coding, data entry, billing, and collections supervisors and staff, supports personnel selection and evaluation, resolves employee relations issues, and works to improve KPI metrics.

Requirements

Bachelor’s degree in business administration, healthcare, or a related field, or equivalent experience.
Ten years of billing experience in a healthcare environment.
Seven years of progressive leadership experience.
Knowledge of revenue cycle management functions, including data entry, ICD-10 coding, accounts receivable management, and remittance application.
Proficiency in Microsoft Office Suite, specifically Word, Excel, and Outlook, and general working knowledge of the Internet for business use.
Ability to work in a fast-paced, deadline-driven environment.
Proficient verbal and written communication skills.
Ability and willingness to share and receive information and ideas from all levels of the organization.
Commitment to team and organizational goals and willingness to participate with and help other team members.
Ability to listen to and understand client/customer needs and exceed service and quality expectations.
Ability to establish and continually reassess procedures and processes to deliver quality results and support continuous improvement.

Nice To Haves

Knowledge of medical anatomical pathology.

Responsibilities

Build and oversee the full RCM Integrity program, from patient services to claims submission and collections, ensuring compliance with payer and ASCP requirements.
Conduct standard RCM risk assessments and audits across in-house and offshore practices, identify vulnerabilities, and implement corrective action plans.
Advise senior leadership on billing integrity, regulatory compliance, and financial risk management.
Recommend process improvements and implement approved changes to enhance operational performance.
Serve as the primary liaison for escalated RCM issues, partnering with clinicians, sales, third-party billing vendors, and billing staff.
Develop, document, and implement approved revenue cycle policies, procedures, and workflows aligned with regulations, payer contracts, and reporting requirements.
Administer payer portals and EDI connectivity with third-party payors.
Remain current with reimbursement regulation changes and notify and train staff on significant coding and billing changes.
Collaborate with management on operational performance and necessary operational changes.
Gather and review reimbursement data, analyze results, prepare reports, and oversee resolution of identified issues.
Train clinicians, sales, and billing department staff.
Assist with selection, training, and performance evaluation of supervisors and staff.
Plan, direct, and supervise coding, data entry, billing, and collections supervisors and staff to ensure timely, accurate, and complete processing while meeting quality and production goals.
Resolve employee relations issues and recommend disciplinary action when required.
Focus on improving KPI metrics.