Excellent organizational skills and attention to detail
Responsibilities
Lead and oversee various RCM teams including billing and prior authorization
Monitor team productivity and ensure revenue cycle goals are met
Ensure accurate and timely completion of billing and collections activities
Communicate effectively with internal and external stakeholders
Analyze reports and identify trends to inform operational strategies
Maintain operational workflows to enhance efficiency and compliance
Provide training and mentorship to staff, fostering continuous improvement
Benefits
Medical, Dental, and Vision Insurance
PTO
Variety of 401K options with matching
Annual Continuing Education Allowance
Life Insurance
Short/Long Term Disability
Paid maternity/paternity leave
Mental Health Day
Calm subscription for all employees
Full Job Description
Day in the Life of a RCM Senior Manager
Provide senior-level leadership and oversight for assigned RCM teams, including Eligibility Verification, Prior Authorization, Billing Call Center, and RCM Buy & Bill teams.
Manage, monitor, and track team productivity on a daily, weekly, and monthly basis to ensure operational expectations, performance benchmarks, and revenue cycle goals are achieved.
Ensure billing, collections, payment posting, adjustments, eligibility verification, authorizations, claim follow-up, denials, credits, and accounts receivable activities are completed timely and accurately.
Promptly respond to internal and external requests for information and ensure appropriate follow-up to all interactions, questions, and concerns.
Initiate and maintain direct contact with field staff, center operations, leadership, and cross-functional partners to support proactive issue resolution and timely responses.
Deliver required reports and operational updates to the Senior RCM Director and senior leadership; identify and communicate resolution plans for payor denial trends, authorization barriers, inaccurate charges, vendor concerns, workflow gaps, and reimbursement issues.
Review monthly and periodic reports, analyze outcomes, identify trends, and communicate findings, risks, and recommendations to leadership and staff.
Maintain standardized operational workflows to improve efficiency, quality outcomes, compliance, and maximized revenue.
Effectively use dashboards, productivity trackers, issue logs, and reporting tools to monitor performance, identify risks, and demonstrate results.
Meet regularly with staff individually and as a group to review updates, reinforce expectations, address barriers, and support continued development.
Provide training, mentoring, coaching, and constructive feedback to staff to support policy adherence, procedural accuracy, productivity, and performance improvement.
Analyze and address staff performance, conduct, timekeeping, attendance, workload coverage, training needs, and other staffing matters in a timely, professional, and appropriate manner.
Professionally interact with company teams, center operations, patients, payers, vendors, and external partners to resolve questions, concerns, claim issues, and revenue cycle barriers.
Stay current with company policies, procedures, payer requirements, CMS guidelines, claim submission requirements, reimbursement rules, and applicable compliance standards.
Analyze accounts receivable trends, including denials, unbilled claims, credit balances, authorization delays, claim holds, payer-specific issues, and reimbursement concerns; communicate with appropriate teams to support timely resolution.
Partner with RCM leadership and other departments to identify operational gaps, develop solutions, streamline workflows, and support process improvement initiatives.
Maintain and use standard issue tracking tools for meeting agendas, minutes, historical reference, issue resolution, and documentation of decisions agreed upon with RCM leadership.
Support Change Management initiatives, including workflow updates, system changes, process standardization, and communication of revised expectations to impacted teams.
Promote a culture of accountability, collaboration, professionalism, compliance, and continuous improvement within assigned teams.
Perform other duties as assigned.
Schedule & Locations
This position will be a hybrid role and requires regular travel to our headquarters in Greenville, SC. Expectations are every other week in Greenville, SC office.
Education and Licensure Requirements
Minimum of 5+ years of experience in Revenue Cycle Management, medical billing, accounts receivable, claims resolution, prior authorization, eligibility verification, payer reimbursement, or a related healthcare operations field.
Prior leadership or supervisory experience required; senior-level management experience preferred.
Must have at least 4 years of EDI resolution experience.
General knowledge of HCPCS, CPT-4, ICD-9/ICD-10 coding, and medical terminology.
Familiarity with CMS guidelines, payer requirements, and regulations for claim submission and reimbursement.
Accounting skills preferred.
Strong problem-solving skills with the ability to define problems, collect data, establish facts, draw valid conclusions, and implement corrective action.
Ability to maintain constant mental alertness, attention to detail, and a high degree of accuracy when completing assignments.
Excellent organizational skills with the ability to manage multiple teams, competing priorities, deadlines, and operational initiatives.
Smart, driven, and dependable with an exceptional work ethic and the ability to follow oral and written instructions through completion.
Highly detail-oriented with the ability to work well independently and in a group setting.
College or university degree preferred.
Equivalent combination of education, experience, and demonstrated revenue cycle leadership may be considered.
Healthcare revenue cycle leadership experience across multiple operational functions preferred.
Position Benefits
Medical, Dental, and Vision Insurance
PTO
Variety of 401K options including a match program with no vesture period
Annual Continuing Education Allowance (in related field)
