Bachelor's degree in Healthcare Administration, Finance, Accounting, or a related field
Extensive experience in revenue cycle management with a track record of reducing days in A/R, denials, and improving cash posting
Strong leadership and supervisory skills with experience in staff training and development
Knowledge of healthcare regulations, HIPAA, billing guidelines, and compliance requirements
Requirements:
Lead and supervise the RCM department, set performance goals, organize workflow, monitor productivity, and oversee staff training and development
Optimize charge capture and coding, implement revenue cycle QA programs, and conduct internal audits to proactively identify and address issues
Manage denials, appeals, payment posting, collections, and financial reconciliation to ensure timely and accurate reimbursement
Ensure compliance with healthcare regulations and billing guidelines; generate and present revenue cycle KPIs and reports to leadership
Job description
The RCM Manager role focuses on maximizing revenue, reducing accounts receivable, and ensuring timely and accurate reimbursement from payers. In addition, this role collaborates with various teams to identify and resolve issues related to denials, appeals, payment posting, collections, and financial reconciliation.
RESPONSIBILITIES AND DUTIES
Supervisory - Set goals for performance and deadlines and communicate them to team members. Organize workflow and ensure that employees understand their duties or delegated tasks. Monitor employee productivity and provide constructive feedback and coaching. Receive complaints and resolve problems. Review departmental policies and procedures, make adjustments where needed, and communicate with team members to ensure those are followed properly. Maintain timekeeping records. Prepare and submit performance reports. Be involved in the employee recruiting process and ensure that employees are properly trained.
Staff Training and Development - Provide guidance, training, and professional development opportunities to staff. Foster a culture of continuous improvement and excellence.
Interpersonal Relations – Communicate and Collaborate with all internal and external parties in a positive manner, displaying a personal commitment to achieving the goals and objectives of the department and the organization.
Financial Reporting - Generate and analyze reports on key performance indicators related to revenue cycle operations. Provide regular reporting to leadership on revenue cycle performance.
Compliance - Stay up to date on healthcare regulations, billing guidelines, and industry changes to ensure compliance.
Specific Responsibilities: Charge Capture and Coding Review – Implement processes to optimize charge capture, including conducting regular audits. Revenue Cycle Quality Assurance – Establish and maintain quality assurance programs to monitor and improve revenue cycle operations. Conduct internal audits and reviews to identify and address issues proactively.
OTHER
Performs other duties as assigned by supervisor.
Completes all assigned AP training (such as CPR, OSHA, HIPAA, Compliance, Information Security, others) within designated timeframes.
Complies with Allergy Partners and respective hub/department policies and reports incidents of policy violations to a Supervisor/Manager/Director, Department of Compliance & Privacy or via the AP EthicsPoint hotline.
Models the AP Code of Conduct and demonstrates a commitment to the AP Compliance Program, standards and policies.
SUPERVISORY RESPONSIBILITIES
This position will supervise positions within the RCM department.
TYPICAL PHYSICAL DEMANDS
Physical demands are moderate with occasional lifting of items weighing approximately 20-30 pounds. Position requires prolonged sitting, some bending, stooping, and stretching. Working under stress and use of telephone required. Good eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is also required. Employee must have normal range of hearing and vision must be correctable to normal range to record, prepare, and communicate appropriate reports.
