RCM Aging Manager
2 days ago
ClinicMind's core values—Excellence · Learning · Teamwork guide everything we build.With 150 in‑house analysts, half a dozen BPO partners, and a proprietary billing platform, we now need a manager to deliver best‑in‑class collections, continue to improve performance, automate, and meet the RCM needs of a rapidly growing client base.Position Summary:The RCM Aging Manager is responsible for overseeing the resolution and collection of aged medical insurance claims to ensure timely and accurate reimbursement. This role leads a team of billing and follow-up specialists focused on reducing outstanding accounts receivable (AR), identifying root causes of claim denials or delays, and implementing process improvements to prevent future aging. The manager serves as the key liaison between billing staff, payers, and internal departments to enhance claim performance and cash flow.Key Responsibilities:Leadership & OversightSupervise a team of billing and collections specialists handling aged or unresolved insurance claims.Assign workloads, set performance goals, and monitor productivity and quality metrics.Conduct regular team meetings to review AR status, payer trends, and action plans.Provide training, mentorship, and performance evaluations for team members.Claims Management & ResolutionOversee the daily review and follow-up of aged insurance claims (commercial, government, PIP, workers' comp, and other third-party payers).Ensure appropriate actions are taken on denied, underpaid, or unpaid claims.Develop and implement work queues, escalation procedures, and aging reports to prioritize collection efforts.Collaborate with payers to resolve complex or disputed claims and obtain proper reimbursement.Monitor timely filing limits and ensure corrective actions are completed before claims are at risk of write-off.Data Analysis & ReportingAnalyze AR aging reports to identify trends, bottlenecks, and payer-specific issues.Prepare weekly and monthly performance reports, including recovery rates, claim volumes, and aging metrics.Track key performance indicators (KPIs) such as AR days, denial rates, and collection effectiveness.Recommend process improvements to streamline claims management and reduce aging inventory.Compliance & Quality AssuranceEnsure billing and follow-up activities comply with federal, state, and payer-specific regulations.Maintain adherence to HIPAA and organizational privacy/confidentiality standards.Partner with compliance and quality teams to correct systemic billing or coding issues.Collaboration & CommunicationWork closely with coding, billing, and denial management teams to resolve issues impacting aged claims.Communicate with internal departments to gather documentation or clarification necessary for claim resolution.Represent the department in meetings related to payer performance and AR reduction strategies.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 experience in medical billing, claims follow-up, or insurance collections.2+ years of supervisory or management experience within a healthcare billing or revenue cycle environment preferred.Strong understanding of payer rules, EOBs, denial management, and reimbursement methodologies.Skills & Competencies:Deep knowledge of medical billing and insurance claim processes.Proficiency in billing systems and electronic health record (EHR) software.Strong analytical and problem-solving skills.Excellent communication, leadership, and team management abilities.High attention to detail and organizational skills.Performance Metrics:Reduction in aged AR (especially >120 days).Increased collection rates and decreased denial ratios.Team productivity and claim resolution turnaround time.Compliance with payer and regulatory guidelines.Staff engagement and retention within the department. Must Have:High comfort level working on Eastern Time Zone/US Shift Good internet access at homeMobile HotspotLaptop/Desktop with at least 16 GB
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