Revenue Cycle Manager

Job Title: Revenue Cycle Manager (RCM)

Location: [Insert Location]

Position Type: Full-Time

Job Summary:

We are seeking a dynamic and detail-oriented Revenue Cycle Manager (RCM) to oversee the daily operations related to the revenue cycle process within our outpatient services. The RCM Manager will be responsible for managing the entire process from patient registration to final payment, ensuring financial efficiency, compliance with healthcare regulations, and optimizing revenue cycle performance. This role requires a proactive leader with a deep understanding of outpatient medical billing, coding, insurance processes, and healthcare financial operations.

Key Responsibilities:

• Oversee Revenue Cycle Operations: Manage all aspects of the revenue cycle for outpatient services, including patient registration, insurance verification, coding, billing, and collections.

• Process Improvement: Develop and implement policies, procedures, and best practices to optimize revenue cycle efficiency and financial performance.

• Team Leadership: Lead and manage a team of billing and coding professionals. Provide guidance, mentorship, and training and conduct performance evaluations to enhance team productivity.

• Compliance & Regulation: Ensure adherence to healthcare regulations, payer guidelines, and industry standards, including HIPAA and reimbursement models.

• Collaboration: Work closely with clinical and administrative teams to streamline processes, improve workflow efficiency, and ensure the accuracy of patient information.

• Denial Management: Identify and resolve billing discrepancies, denials, and rejections, collaborating with insurance carriers and patients to ensure timely payments.

• Performance Monitoring: Monitor key performance indicators (KPIs) related to the revenue cycle, implementing strategies to reduce days in accounts receivable (AR), minimize claim rejections, and improve overall revenue cycle metrics.

• Reporting & Analysis: Provide regular reporting to senior management on revenue cycle performance, emerging trends, and opportunities for process improvements.

• Insurance Relations: Develop and maintain relationships with insurance payers. Negotiate payment terms and resolve escalated billing issues efficiently.

• Industry Knowledge: Stay informed about healthcare industry trends, payer policies, and updates to billing and coding standards to ensure ongoing compliance and optimization of revenue cycle operations.

Qualifications:

• Education: Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.

• Certifications: Certification in healthcare revenue cycle management (e.g., CHC, CPC, or AAPC) preferred.

• Experience:

  • Minimum of 5 years of experience in revenue cycle management.
  • At least 2 years of experience in a supervisory or managerial role.

• Technical Skills:

  • Strong knowledge of outpatient medical billing, coding (CPT, ICD-10, HCPCS), and insurance verification processes.
  • In-depth understanding of healthcare reimbursement models, payer processes, and HIPAA regulations.

• Leadership Skills: Strong leadership abilities, with experience managing and motivating teams effectively.

• Communication Skills: Exceptional verbal and written communication skills, with the ability to collaborate professionally with patients, staff, and external stakeholders.

• Problem-Solving: Excellent analytical, organizational, and problem-solving skills.

Job Title: Revenue Cycle Manager (RCM)

Location:Memphis, TN

Position Type: Full-Time - Direct Hire
Schedule: M-F in office

Job Summary:

We are seeking a dynamic and detail-oriented Revenue Cycle Manager (RCM) to oversee the daily operations related to the revenue cycle process within our outpatient services. The RCM Manager will be responsible for managing the entire process from patient registration to final payment, ensuring financial efficiency, compliance with healthcare regulations, and optimizing revenue cycle performance. This role requires a proactive leader with a deep understanding of outpatient medical billing, coding, insurance processes, and healthcare financial operations.

Key Responsibilities:

• Oversee Revenue Cycle Operations: Manage all aspects of the revenue cycle for outpatient services, including patient registration, insurance verification, coding, billing, and collections.

• Process Improvement: Develop and implement policies, procedures, and best practices to optimize revenue cycle efficiency and financial performance.

• Team Leadership: Lead and manage a team of billing and coding professionals. Provide guidance, mentorship, training, and conduct performance evaluations to enhance team productivity.

• Compliance & Regulation: Ensure adherence to healthcare regulations, payer guidelines, and industry standards, including HIPAA and reimbursement models.

• Collaboration: Work closely with clinical and administrative teams to streamline processes, improve workflow efficiency, and ensure the accuracy of patient information.

• Denial Management: Identify and resolve billing discrepancies, denials, and rejections, collaborating with insurance carriers and patients to ensure timely payments.

• Performance Monitoring: Monitor key performance indicators (KPIs) related to the revenue cycle, implementing strategies to reduce days in accounts receivable (AR), minimize claim rejections, and improve overall revenue cycle metrics.

• Reporting & Analysis: Provide regular reporting to senior management on revenue cycle performance, emerging trends, and opportunities for process improvements.

• Insurance Relations: Develop and maintain relationships with insurance payers. Negotiate payment terms and resolve escalated billing issues efficiently.

• Industry Knowledge: Stay informed about healthcare industry trends, payer policies, and updates to billing and coding standards to ensure ongoing compliance and optimization of revenue cycle operations.

Qualifications:

• Education: Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.

• Certifications: Certification in healthcare revenue cycle management (e.g., CHC, CPC, or AAPC) preferred.

• Experience:

  • Minimum of 5 years of experience in revenue cycle management.
  • At least 2 years of experience in a supervisory or managerial role.

• Technical Skills:

  • Strong knowledge of outpatient medical billing, coding (CPT, ICD-10, HCPCS), and insurance verification processes.
  • In-depth understanding of healthcare reimbursement models, payer processes, and HIPAA regulations.

• Leadership Skills: Strong leadership abilities, with experience managing and motivating teams effectively.

• Communication Skills: Exceptional verbal and written communication skills, with the ability to collaborate professionally with patients, staff, and external stakeholders.

• Problem-Solving: Excellent analytical, organizational, and problem-solving skills.