RCM Manager

Job Title: RCM Manager

This role is responsible for the daily operations of the medical Revenue Cycle Management (RCM) department, overseeing claims processing, denial management, collections, and payment posting within a healthcare context. The RCM Manager will ensure efficient workflows, maximize revenue capture, and continuously improve key performance metrics such as clean claim rates, AR aging, and denial resolution. The ideal candidate will have a strong grasp of RCM industry standards, exceptional analytical skills, and the ability to lead a team to exceed client service expectations. This position operates on an EST time schedule.

Revenue Cycle Operations Oversight:

o Lead all end-to-end medical revenue cycle functions, including claims submission, charge capture, medical billing, payment posting, denial management, and collections, ensuring accuracy and compliance with healthcare industry regulations.

o Establish and maintain efficient workflows, prioritizing high-quality service and prompt claims resolution to minimize AR aging.

o Monitor key revenue cycle metrics (e.g., clean claim rate, denial rate, AR days) to ensure optimal financial performance and adherence to client service standards.

Denial Management and Claims Resolution:

o Oversee the medical claims denial management process, developing strategies to prevent denials, reduce denial rates, and improve overturn rates on appealed claims.

o Collaborate with coding, billing, and follow-up teams to identify denial patterns and implement corrective actions.

o Ensure timely and accurate medical claims resolution, working with insurance companies and clients as needed for complex healthcare claims.

Team Leadership and Development:

o Lead, coach, and develop the RCM team through training and mentorship, aligning performance with department goals.

o Set team goals, regularly review progress, and provide constructive feedback.

o Foster a collaborative culture focused on client satisfaction, efficiency, and professional growth.

Client and Stakeholder Communication:

o Serve as the primary client contact for RCM performance, addressing inquiries, providing updates, and delivering data-driven insights.

o Conduct regular client meetings to review performance, address concerns, and recommend improvements for collections, payment posting, and AR management.

o Collaborate with other departments (e.g., coding, compliance) for cohesive RCM operations.

Process Improvement and Compliance:

o Continuously analyze and optimize RCM workflows to improve efficiency, reduce AR aging, and increase revenue capture, using data and feedback.

o Ensure compliance with federal, state, and industry regulations for claims processing, billing, and collections, maintaining high standards of data security and patient confidentiality.

o Stay informed about industry trends and best practices, implementing relevant changes to enhance RCM services.

· 5+ years of experience in medical revenue cycle management, with at least 2 years in a management or supervisory role.

· Extensive knowledge of medical claims processing, denial management, and AR follow-up.

· Excellent interpersonal and communication skills.

· Proven ability to build and maintain strong client relationships.

· Provide leadership and guidance on industry, regulatory, and billing/collection compliance to the team.

· Coach, develop, and manage the RCM team, including hiring, performance evaluations, and corrective actions, to ensure high customer satisfaction and professional growth.

· Drive continuous improvement, standardization, and risk mitigation for service delivery processes.

· Oversee financial responsibilities for the RCM and PS teams, including P&L, OPEX, and forecasting, in collaboration with leadership.

· Set, monitor, and achieve departmental goals to optimize performance and efficiency.

· Ensure quarterly executive client meetings are conducted to review service level expectations and business overview.

· Travel occasionally for customer service visits, user group meetings, and conferences.

The hiring range for this role is $50,000 to $60,000 USD per year. Final compensation will be based on experience, skills, market conditions, and internal equity.

Benchmark Solutions, a division of Harris Computer, is made up of a group of hard-working individuals that view the company as an extension of their family. We pride ourselves on our low turnover rates with our most recent hire having 1.5 years of service, but most employees having 10+ years tenure. Originally a software company, the RCM team was added in 1998 & over the years have served over 150 practices at varying levels. We can potentially be full service or, in special circumstances, focused on a specific area of concern for the client. We encourage employees to pursue additional training to improve their value to the team.

This role will come into contact with Protected Health Information, Personal Identifiable Information or Privacy Records, and it is essential that all employees adhere to confidentiality requirements as outlined in the Employee Handbook and Harris’ Security and Privacy policies, as well as apply the concepts learned in the annual Security Awareness training.