Senior Manager
3 weeks ago
- The Senior Manager of Revenue Cycle Management (RCM) will be responsible for the overall performance and strategic direction of the revenue cycle for our clients.
- This role requires a highly experienced and results-oriented individual with a deep understanding of healthcare reimbursement, coding, denials management, and team leadership.
- The Senior Manager will lead a team of RCM professionals and will be accountable for optimizing the revenue cycle, improving key performance indicators, and ensuring compliance with all relevant & Team Management:
- Lead, mentor, and develop a high-performing RCM team.
- Set clear performance expectations and provide regular feedback and coaching.
- Foster a positive and collaborative team environment.
- Conduct performance reviews and identify training needs.
- Effectively delegate tasks and responsibilities.
Revenue Cycle Management Oversight:
- Oversee all aspects of the revenue cycle, including billing, coding, claims submission, payment posting, denial management, and collections.
- Develop and implement strategies to optimize the revenue cycle and improve key performance indicators (KPIs) such as days sales outstanding (DSO), clean claim rate, and denial rate.
- Monitor and analyze RCM performance metrics and identify areas for improvement.
- Implement best practices for revenue cycle management.
- Ensure compliance with all applicable regulations and payer requirements.
Denials Management:
- Develop and implement a robust denials management program.
- Analyze denial trends and identify root causes.
- Implement corrective actions to prevent future denials.
- Oversee the appeals process for denied claims.
Medical Coding:
- Oversee the medical coding process to ensure accuracy and compliance.
- Stay up-to-date on coding guidelines and regulations.
- Collaborate with coding staff to resolve coding issues.
Managed Care:
- Manage relationships with managed care organizations.
- Negotiate contracts and reimbursement rates.
- Monitor payer performance and identify trends.
Practice Management:
- Collaborate with practice management teams to ensure seamless integration of RCM processes.
- Identify opportunities to improve efficiency and effectiveness of practice operations.
Reporting & Analysis:
- Prepare and present regular reports on RCM performance to senior management.
- Analyze data to identify trends and opportunities for improvement.
- Develop and implement action plans to address identified issues.
Process Improvement:
- Continuously evaluate and improve RCM processes.
- Identify and implement automation opportunities.
- Stay up-to-date on industry best practices and emerging Bachelor's/ master's degree in Healthcare Administration, Business Administration, or a related field.
- Minimum of 12+ years of experience in medical billing, collections, and business process outsourcing within the healthcare industry.
- Minimum of 5 years of experience in a leadership or management role overseeing RCM operations.
- Proven track record of success in optimizing revenue cycle performance.
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