Overview
The Revenue Cycle Manager is responsible for the overall leadership, performance, and optimization of the insurance and patient revenue cycle processes across the organization.
This position oversees the Insurance A/R Supervisor and Insurance AR Specialist teams to ensure timely and accurate claim submission, follow-up, and reimbursement.
This role partners closely with practice managers to strengthen front-end revenue operations, including patient A/R management and over-the-counter (OTC) collection best practices to ensure financial excellence across the full patient and insurance payment lifecycle.
The Revenue Cycle Manager develops strategies to improve cash flow, reduce aged A/R, increase first-pass claim acceptance, and maintain compliance with payer and regulatory requirements.
Responsibilities
Provide leadership for all insurance A/R, billing, and collections functions.
• Directly supervise the Insurance A/R Supervisor and Insurance A/R Specialist
• Develop and communicate clear workflows, accountability measures, and escalation procedures for unresolved claims and denials.
• Oversee all insurance accounts receivable functions to ensure timely resolution of outstanding claims and reduction of aged A/R (30/60/90+).
• Track and report cash collection, aging trends, and denial patterns.
• Analyze key performance data to identify root causes of delayed payments or rejections and lead corrective actions.
• Evaluate and refine revenue cycle workflows to improve first-pass claim acceptance and reduce rework.
• Assist with developing and maintaining standard operating procedures (SOPs) for insurance billing, follow-up, and documentation.
• Oversee onboarding and training programs for new insurance A/R staff, ensuring understanding of systems, workflows, and payer guidelines.
• Conduct regular performance reviews and provide coaching to promote skill development and accountability to A/R team members.
• Partner with operations, practice managers, front office, and clinical teams to ensure all required claim attachments are accurately captured and available in the patient's chart prior to submission.
• Serve as the primary liaison between the RCM department and leadership, providing regular updates on department performance and process improvements.
• Partner with Practice Managers to monitor and improve patient A/R aging, ensure accurate patient balance collection, and reinforce over-the-counter (OTC) collection best practices. Supervise daily activities of the Insurance A/R Support Specialists, ensuring claims and errors are completed according to established timelines and workflows.
• Provide coaching, feedback, and ongoing training to enhance accuracy, productivity, and professional development of AR team members
.Review unresolved claims for trends, timely filing risks, or payer-specific issues, escalating to RCM leadership as appropriate.
• Ensure claims are submitted daily.
• Ensure DentalXChange errors are addressed promptly, and systemic causes are identified and resolved.
• Oversee utilization of Denticon Task Manager to ensure all tasks and claim notes are up to date and accurate.
• Ensure claims are properly submitted with required attachments through Denticon.
Performance Metrics (KPIs)
• 99% Cash Collection Rate
• Insurance AR Aging Target:
55% in 0-30 days
20% in 31-60 days
15% in 61-90 days
10% in over 90 days
• 90% First-pass acceptance rate
