RCM Manager

Manage the complete revenue cycle from patient registration and eligibility verification through billing, claims processing, payment posting, denial management, and collections.

Lead, supervise, and develop the RCM team, including billing, claims, AR, denial, and collection staff.

Monitor daily, weekly, and monthly RCM performance and ensure achievement of operational and financial targets.

Oversee accurate and timely submission of insurance claims.

Monitor outstanding accounts receivable and develop strategies to reduce aging balances.

Analyze and resolve claim denials, rejections, underpayments, and payment discrepancies.

Identify recurring billing and coding issues and coordinate corrective actions with relevant departments.

Maintain effective relationships with insurance companies, TPAs, and other payers.

Review payer contracts, reimbursement terms, and payment trends to identify revenue-impacting issues.

Ensure accurate payment posting, reconciliation, and follow-up on unpaid or partially paid claims.

Develop and implement processes to reduce claim errors, improve clean-claim rates, and accelerate collections.

Prepare and present RCM dashboards and management reports covering KPIs, AR aging, collections, denials, and claims performance.

Establish team KPIs and conduct regular performance reviews.

Coordinate with Finance and Accounting for reconciliation of collections and receivables.

Work with Medical Coding and Clinical teams to address documentation, coding, and billing discrepancies.

Ensure compliance with applicable healthcare regulations, payer requirements, internal policies, and data-protection standards.

Support internal and external audits and ensure timely resolution of audit findings.

Identify opportunities for automation, process improvement, and cost reduction within the revenue cycle.

Escalate significant payer, operational, compliance, or revenue risks to senior management.

Manage the complete revenue cycle from patient registration and eligibility verification through billing, claims processing, payment posting, denial management, and collections.

Lead, supervise, and develop the RCM team, including billing, claims, AR, denial, and collection staff.

Monitor daily, weekly, and monthly RCM performance and ensure achievement of operational and financial targets.

Oversee accurate and timely submission of insurance claims.

Monitor outstanding accounts receivable and develop strategies to reduce aging balances.

Analyze and resolve claim denials, rejections, underpayments, and payment discrepancies.

Identify recurring billing and coding issues and coordinate corrective actions with relevant departments.

Maintain effective relationships with insurance companies, TPAs, and other payers.

Review payer contracts, reimbursement terms, and payment trends to identify revenue-impacting issues.

Ensure accurate payment posting, reconciliation, and follow-up on unpaid or partially paid claims.

Develop and implement processes to reduce claim errors, improve clean-claim rates, and accelerate collections.

Prepare and present RCM dashboards and management reports covering KPIs, AR aging, collections, denials, and claims performance.

Establish team KPIs and conduct regular performance reviews.

Coordinate with Finance and Accounting for reconciliation of collections and receivables.

Work with Medical Coding and Clinical teams to address documentation, coding, and billing discrepancies.

Ensure compliance with applicable healthcare regulations, payer requirements, internal policies, and data-protection standards.

Support internal and external audits and ensure timely resolution of audit findings.

Identify opportunities for automation, process improvement, and cost reduction within the revenue cycle.

Escalate significant payer, operational, compliance, or revenue risks to senior management.

Bachelor's degree in Healthcare Management, Finance, Business Administration, Accounting, or a related field.

Professional certification in RCM, medical billing, coding, or healthcare management is an advantage.

5–8 years of experience in healthcare revenue cycle management, including 2–3 years in a supervisory or managerial role.

Strong knowledge of medical billing, claims processing, denial management, AR follow-up, and payer processes.

Experience working with healthcare providers, insurance companies, and TPAs.

Strong analytical, problem-solving, leadership, and communication skills.

Proficiency in MS Excel and healthcare billing/RCM systems.

Experience with dashboards, KPI reporting, and process improvement.