D+H

RCM Manager

D+H • $80K — $95K *
Raleigh, NC 27610In-Person
Healthcare
Less than 5 years of experience
Today
Be an Early Applicant
Job Overview by Ladders

Qualifications

  • 5-7 years of experience in revenue cycle management (RCM) or medical billing
  • Proficient in CPT, ICD-10 coding, and medical billing processes
  • Demonstrated leadership ability in managing a team
  • Strong knowledge of payer websites and medical billing software
  • Excellent communication and customer service skills
  • Experience with various medical specialties, including Psychiatry and General Surgery

Responsibilities

  • Manage team productivity by overseeing the follow-up on unpaid and underpaid claims
  • Meet with clients to discuss billing progress and resolve issues
  • Ensure accurate entry of charges and reimbursements in the billing system
  • Supervise data entry of payments and adjustments made by staff
  • Foster client relationships by proactively addressing questions and concerns
  • Provide timely reports to RCM management on team and client performance
  • Track and analyze client accounts receivable metrics to identify trends

Benefits

  • Standard work week or flexible hours based on assignments
  • Option to work remotely or in an office environment
  • Opportunities for after-hours support during peak periods
  • Limited PTO during critical business times
  • Commitment to pay transparency and equitable compensation practices
Full Job Description
Manages a RCM team who are responsible for all related medical billing activity for the purpose of maximizing accounts receivable collections for clients. In addition to performing similar work, the Manager will oversee and ensure group productivity and performance in accordance with financial goals to ensure the health of the client's Accounts Receivable Supports RCM Management by efficiently and effectively providing oversight and review of the team, processes and workload.

Responsibilities
  • Responsible for staff productivity for follow-up of all unpaid, denied, and underpaid and overpaid claims. This includes but is not limited to: contacting insurance companies for claim status, reviewing all insurance claims and patient documentation, reviewing and ensuring appropriate coding, handling correspondence, and making appropriate decisions for follow-up action. Must be effective at handling several accounts simultaneously and ensuring maximum accounts receivables and expedient collection turnaround for clients.
  • Meets with Client representatives to review billing progress, status of a accounts and review and resolve any issues presented by clients.
  • Ensures that staff and/or vendor, as applicable enters all charges into the medical billing system accurately and correctly for reimbursement. This includes but is not limited to: ensuring correct CPT codes, modifiers, and ICD codes, authorizations for services, patient demographics, and health insurance data.
  • Responsible for staff who enters all patient, insurance, and third party payments into the medical billing system. This includes a thorough knowledge and understanding of medical EOB's, patient deductibles and co pays, and insurance or third party correspondence, contractual payments and adjustments.
  • Interact with clients and their patients, engage in proactive resolution of issues and timely response to questions and concerns.
  • Strong customer service skills for client satisfaction, health of client AR and management of RCM team members
    o answering client inquiries; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally
    o acts as primary point of contact for team members and provides guidance on work matters
  • Deliver timely required reports to the RCM Management; initiates and communicates the resolution of issues
  • Meet regularly with staff; in-person and as a group to confirm the status of client accounts and build/sustain staff engagement to drive business results and improvements
  • Track clients' AR productivity and health (charge, payments, collections, adjustments) on a daily, weekly and/or monthly basis; as needed to ensure the client and company expectations are met
  • Remain current with company's policies and procedures regarding AR activity such as, reviewing month end reports to insure the AR and cash collections are meeting agreed upon benchmarks, identifying trends, reviewing denial reports
  • Analyze reports to determine when, how and why decrease in clients' AR; includes denials, unbilled, credit issues, holds; determine corrective actions and communicate with client and staff to resolve. Follow up to ensure actions are taken that achieve the results needed and/or determine other resolution needed
  • Review work performed by outside vendors for accuracy and production. Determine changes/improvement needed and works promptly and appropriate with applicable individuals to bring about such changes/improvement
  • Achieve goals set forth by management and compliance requirements
  • Follows, enforces and models adherence to all policies, procedures and processes


Knowledge, Skills and Abilities
  • Extensive knowledge with email, search engines, Internet
  • Ability to effectively use payer websites and LaserFiche
  • Intermediate practical knowledge and use of Microsoft products; Outlook, Word, Excel, PowerPoint
  • Preferred experience with MS Access, Crystal reports
  • General knowledge of and the ability to learn/regularly use various billing systems, EMR's and interfaces
  • Previous experience with various billing systems, such as Next Gen, Pro, Allscripts, Epic and others
  • Accounting skills preferred
  • Knowledge of CPT, ICD10 and modifiers.
  • Experience in specialties such as Psychiatry, Internal Medicine, Orthopedics, General Surgery
  • Familiar with HMO and IPAs, Medicare Fee for Service Plans and Commercial Payers
  • Strong communication skills


Working Arrangements
  • Standard work week or as defined by assignment requirements
  • Primarily works in standard office environment or remotely
  • May require after-hours, on-call support and/or holidays
  • On-call and after hours work during peak times including end of month/quarter/year; during this time PTO is limited to meet business needs


Compensation for this job is subject to market conditions, geographic considerations, the candidate's unique skills and experience, state and local laws, and budget. Our commitment to pay transparency is a testament to our dedication to creating a fair, equitable, and inclusive workplace. By continuously analyzing market trends, staying abreast of changes in state laws, and making budgetary adjustments accordingly, we strive to ensure that our compensation practices reflect the value we place on our associates' unique contributions and support their professional growth.

About D+H

D+H is committed to being the technology partner that financial services organizations trust and rely on to build deeper and more profitable relationships with their own customers. In 1875, when D+H was founded, They may have looked a lot different than we do today, but the core of that commitment – being a trusted provider to our customers – has never changed. They have remained committed to delivering solutions that power our customers’ businesses in increasingly competitive markets. They are proud of their strong and vibrant history - it drives their culture and the way they do business today.

Veradigm Careers

Joining Veradigm presents an unparalleled opportunity to advance a career in healthcare technology with a company at the forefront of innovation and leadership. Veradigm, a leader in providing cutting-edge healthcare solutions, offers a range of job opportunities designed to empower professional growth and personal achievement.

Explore Career Opportunities

Veradigm is actively hiring and seeks professionals who are passionate about making a significant impact in the healthcare industry. With a variety of positions available, from technical roles to customer support, Veradigm ensures that every team member can find a place to excel.

Internship Programs

Veradigm's internship programs offer a robust introduction to the healthcare technology sector, providing hands-on experience and valuable networking opportunities. Interns at Veradigm gain practical skills and knowledge, setting the stage for future employment in a dynamic and evolving industry.

Professional Growth and Development

Veradigm is committed to the professional growth of its employees, offering extensive training and development programs. These initiatives are designed to enhance skills and foster innovation, ensuring that every team member can achieve their career aspirations within the company.

Diversity and Inclusion

At Veradigm, diversity is celebrated and actively promoted through comprehensive diversity training programs. The company believes that a diverse team enriches the workplace culture and drives the innovation that Veradigm is known for.

Benefits and Culture

Employees at Veradigm enjoy a range of benefits that support both their professional and personal lives. The company culture emphasizes teamwork, leadership, and the well-being of its staff, creating an environment where individuals can thrive.

Applying for a Position

Candidates interested in joining Veradigm are encouraged to explore available job opportunities on the Veradigm Careers page. The application process typically involves submitting a resume, completing an interview, and demonstrating how one's skills and experiences align with the company's needs.

Stay Connected with Veradigm Jobs

To stay informed about new openings and company news, potential candidates can sign up for job alert emails. These updates provide insights into Veradigm and highlight how the company continues to lead and innovate within the healthcare sector.

Networking and Career Advancement

Veradigm supports a vibrant professional community where networking and peer interactions are encouraged. This community helps foster relationships that can lead to career advancement and continued employment opportunities within the company.

Join the Veradigm Team

Veradigm is looking for curious, creative, and solution-driven team players. Search open positions that match your skills and interests on the Veradigm Jobs portal and discover how you can contribute to a leader in healthcare technology.

READ CAREERS BLOG

Stay ahead with career tips, insider perspectives, and industry-leading insights you can put to use today—all from the people who work at Veradigm. Explore how Veradigm is shaping the future of healthcare and how you can be a part of this exciting journey.
Learn more about D+H
Industry
Legal & Accounting
Founded
1875
* Ladders Estimates

Similar Jobs

Ad banner background

Get Ready For Your
Next Interview

More Jobs at D+H

More Healthcare Jobs

Find similar RCM Manager jobs:

NationwideRaleigh, NC