The RCM Manager will play a key role in supporting the Director of Revenue Cycle by overseeing day-to-day operations, driving process improvements, and ensuring efficient and accurate billing and collections. This role requires strong leadership, operational expertise, and the ability to build accountability within the team to achieve performance and quality standards.

Key Responsibilities

1. Revenue Cycle Support & Strategy

1. Partner with the Director to develop, implement, and refine revenue cycle strategies, processes, and improvement initiatives.

2. Ensure continuous optimization of billing and collections to maximize revenue.
   
   

2. Operational Oversight

1. Coordinate with Revenue Cycle supervisors and managers to streamline claims submission processes.

2. Perform internal audits of high-value and high-risk claims to identify gaps and drive revenue optimization.

3. Monitor and review all revenue cycle interfaces, recommend solutions, and support the implementation of process enhancements.
   
   

3. Compliance, Policies & SOPs

1. Keep staff and clients updated on billing SOPs, policies, and protocols.

2. Ensure revenue cycle policies and procedures are regularly reviewed, updated, and clearly communicated across the team.
   
   

4. Performance Management & KPIs

1. Establish and enforce KPIs with a focus on reducing turnaround times, improving productivity, and maintaining quality metrics.

2. KPI benchmarks include:

1. Accounts receivable over 120 days: <10%

2. Rejection resubmission: <7 business days

3. Communicate operational bottlenecks and escalate when needed to prevent delays.

4. Track, analyze, and report on productivity to ensure processors meet or exceed targets.
   
   

5. Denials & Error Prevention

1. Coordinate with providers on medical necessity-related denials and implement preventive measures.

2. Compile and analyze billing error data and develop corrective action plans to reduce errors.
   
   

6. Training & Development

1. Conduct training sessions for staff on RCM functions, SOPs, and performance standards.

2. Provide coaching, mentorship, and professional development opportunities to direct reports.

3. Promote accountability, ownership, and alignment with organizational vision, mission, and values.
   
   

7. Leadership & Reporting

1. Prepare audit reports and performance dashboards for leadership review.

2. Anticipate operational challenges, recommend solutions, and ensure leadership is updated on performance outcomes.

3. Participate in special revenue cycle projects and payer contract reviews as assigned.
   
   

Qualifications & Skills

1. Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or related field (Master’s preferred).

2. 5+ years of progressive experience in healthcare revenue cycle management, with at least 2–3 years in managerial position

3. Proven success in managing RCM.