RCM Manager

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

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

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

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Oversee accurate and timely submission of insurance claims.

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

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

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

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

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

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

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

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

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Establish team KPIs and conduct regular performance reviews.

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

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

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

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

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

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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.

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

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

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

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

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

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

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Proficiency in MS Excel and healthcare billing/RCM systems.

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Experience with dashboards, KPI reporting, and process improvement.