RCM AR Follow-Up Manager

Job Description ClinicMind's core valuesExcellence - Learning - Teamwork guide everything we build. With150 inhouse analysts, half a dozen BPO partners, and a proprietary billing platform, we now need a manager to deliver bestinclass collections, continue to improve performance, automate, and meet the RCM needs of a rapidly growing client base. Position Summary The RCM AR Follow-Up Manager oversees the daily operations of the Accounts Receivable team responsible for timely follow-up and resolution of billed medical insurance claims. This role ensures that outstanding claims are pursued, denials are addressed promptly, and payments are collected efficiently to maintain optimal cash flow and reduce aged receivables. The manager serves as the liaison between the AR staff, billing team, payers, and leadership to ensure compliance, productivity, and accuracy in all AR activities. Key Responsibilities - Leadership and Oversight - Supervise, train, and mentor a team of AR follow-up specialists and lead representatives. - Assign workloads, monitor productivity, and track key performance indicators (KPIs) such as Aging and claim resolution rate. - Conduct regular team meetings to discuss performance, process improvements, and payer updates. - Foster a positive, accountable, and results-driven team culture. - AR Management - Oversee the timely and accurate follow-up on all unpaid, underpaid, and denied insurance claims across all payer types. - Ensure all claims are followed up in accordance with payer timely filing limits. - Monitor and analyze aging reports to identify trends, payer issues, and root causes of delays. - Work closely with the billing and cash posting teams to reconcile discrepancies and resolve claim-related issues. - Process and Performance Optimization - Develop and implement policies, procedures, and workflows to streamline AR operations. - Evaluate and improve claim follow-up strategies to enhance collections and minimize rework. - Utilize reports and dashboards to track team performance and identify improvement opportunities. - Collaborate with IT or system administrators to optimize billing software tools and automation. - Payer and Denial Management - Maintain strong relationships with insurance representatives to expedite claim resolution. - Oversee the research and resolution of complex claim denials and payment variances. - Provide feedback to billing and coding teams on denial trends and documentation needs. - Ensure appeals are filed accurately and timely with proper documentation and justification. - Compliance and Quality Assurance - Ensure all AR activities comply with HIPAA, payer contracts, and company policies. - Maintain confidentiality of patient information and financial data. - Conduct periodic quality audits to ensure accuracy in claim follow-up and note documentation. - Stay current with payer regulations, policy changes, and industry best practices. - Reporting and Communication - Prepare and present weekly, monthly, and quarterly AR performance reports to senior management. - Communicate collection trends, issues, and successes across the revenue cycle leadership team. - Recommend actionable strategies to reduce days in AR and improve cash flow. Qualifications - Education: - Associate's or bachelor's degree in business administration, Healthcare Management, or related field preferred. - Equivalent combination of education and experience may be considered. - Experience: - 5+ years of progressive experience in medical billing, AR follow-up, or revenue cycle management. - 2+ years in a supervisory or management role overseeing AR or collections teams. - Strong knowledge of payer policies, denial management, and reimbursement methodologies (commercial, Medicare, Medicaid, PIP, workers comp, etc.). - Skills & Competencies: - Proficiency in billing systems and electronic health record (EHR) software. - Advanced Excel and data analysis skills. - Strong leadership, coaching, and team-building abilities. - Excellent problem-solving, analytical, and organizational skills. - Clear communication and negotiation skills with internal staff and payer representatives. - Ability to manage multiple priorities in a fast-paced environment. - High attention to detail Performance Metrics - Days in AR (goal: maintain below industry benchmark) - AR >90 days percentage - Denial rate and resolution rate - Cash collections to net revenue ratio - Team productivity (claims followed up per day) - Timeliness and accuracy of claim follow-up documentation Must Have - High comfort level working on Eastern Time Zone/US Shift - Good internet access at home - Mobile Hotspot - Laptop/Desktop with at least 16 GB