RCM Manager

Full job description

The RCM Manager is responsible for managing and tracking the productivity of the team and ensuring that billing and collection activities are timely and accurate. The position supports the company’s objective of efficiently and effectively providing management, oversight, and assurance that collections, adjustments, and accounts receivable balances are accurate and meet benchmarks and expectations. In addition, the RCM manager will review monthly reports, analyze outcomes, identify trends, and ensure timely and proactive communication to the team.

Essential Duties and Responsibilities include the following and other duties that are assigned:

• Prompt return and follow-up to all interactions; prompt response to requests for information, both internally and externally.
• Initiate and maintain direct contact with practice consultants (PCs), engaged in proactive resolution of issues and timely response to questions and concerns.
• Delivers timely required reports to the RCM VP; initiates and communicates the resolution of issues, such as payer denial trends, inaccurate charges, vendor input and implementation.
• Meet regularly with staff; in person and as a group to review updates.
• Track AR productivity (charge, payments, collections, adjustments) on a daily, weekly and/or monthly basis; as needed to ensure company expectations are met.
• Professionally interact with PCs and clinic managers to resolve questions and concerns.
• Provide training and mentoring to staff; ensure policy and procedures are followed and improvements occur.
• Stay current with the company's policies and procedures regarding charge activity such as, reviewing month-end reports, and identifying trends.
• Understanding of EDI or billing rules (Tools like Waystar, RCx etc)
• General Knowledge of HCPCS, CPT-4 and ICD9-10 coding and/or medical terminology.
• Familiar with CMS guidelines and regulations for claim submission and reimbursement.
• Analyze reports to determine when, how, and why decrease in clients’ AR; including denials, unbilled, credit issues; and holds; communicate with clients and staff to resolve.
• Analyze and address staff performance, conduct, and other problems in a timely and professional manner; offering counseling, correction, and discipline as appropriate.
• Maintain standardized operational workflows to ensure efficiencies, quality outcomes, and maximized revenue.
• Works with IT team to ensure file maintenance is accurate and current. Routinely review and monitor reporting with the billing agent to ensure the accuracy of master files, including payers, denials, and master fee schedules.
• Effectively use developed dashboard reporting to maintain and use to demonstrate performance.
• Perform period reviews to mentor and give constructive feedback to improve performance.
• Handle and manage internal staffing issues as regards time clock, time-off, covering workloads, training, and answering questions on subordinates’ duties and responsibilities.
• Effectively use standard issue tracking tools to be used in agendas, minutes, and as a historical reference of issues resolved and decisions agreed upon with RCM VP.
• Ensure compliance with company policies, procedures, and quality standards throughout the project lifecycle
• Continuously identify and implement process improvements to enhance project delivery and efficiency
• Other duties as assigned.

Qualification Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

• The position requires constant mental alertness, attention to detail, and a high degree of accuracy required in completing all assignments.
• Strong problem-solving skills. Smart, driven, exceptional work ethic.
• Must be able to follow oral and written instructions and follow –through on all assignments.
• Excellent organizational skills.
• Highly detailed-oriented.
• Ability to work well in a group setting and independently.

Education and/or Experience:

• College or University degree preferred.
• 6 years of experience in same/related field.
• Accounting skills preferred.

Salary will be based on the experience level of the applicant.