What are the responsibilities and job description for the Senior RCM Manager position at MedCare MSO?
Job Description
About the Role : We are seeking a highly skilled and experienced Senior Revenue Cycle Management (RCM) Manager to lead and optimize our revenue cycle operations. This role requires a deep understanding of medical billing, coding, and revenue cycle workflows, with a strong focus on compliance, process improvement, and team leadership. The ideal candidate will have a proven track record of managing complex RCM processes, driving operational efficiency, and ensuring compliance with regulatory requirements.
Key Responsibilities :
Revenue Cycle Management :
Oversee all aspects of the revenue cycle, including collections, payment posting, medical billing, and denial management.
Ensure accurate and timely submission of claims using CPT, ICD-10, and HCPCS codes, as well as UB-04 and HCFA 1500 claim forms.
Monitor and optimize key performance indicators (KPIs) such as days in accounts receivable (DAR), clean claim rates, and denial rates.
Compliance and Regulatory Knowledge :
Ensure compliance with HIPAA, Medicare, Medicaid, and third-party payer regulations.
Stay current with changes in healthcare regulations, payer policies, and coding updates, and implement necessary changes to workflows and systems.
Conduct regular audits to ensure accuracy and adherence to billing and coding guidelines.
Technology and Systems :
Possess current knowledge of technologies in the health information sector and their applications, including practice management software and EHR systems.
Utilize advanced tools for claims scrubbing, eligibility verification, and denial management to optimize revenue cycle performance.
Maintain and configure system settings to support RCM workflows and ensure data integrity.
Team Leadership and Training :
Supervise, train, and mentor RCM staff, ensuring high performance and professional development. Develop and deliver training materials, process maps, and step-by-step guides for staff and vendors.
Foster a culture of continuous improvement and accountability within the RCM team.
Stakeholder Communication :
Communicate effectively with staff, colleagues, patients, physicians, and insurers in person, over the telephone, and in writing.
Provide the right answers to inquiries from all customers (both internal and external) based on profound knowledge of company policies and procedures.
Collaborate with payers to resolve complex billing issues and optimize reimbursement rates.
Process Improvement :
Develop, implement, and administer effective RCM workflows and policies.
Handle problems consisting of multiple variables in an organized manner, ensuring practice timelines are met.
Display exceptional initiative and work under little or no supervision to drive process improvements.
Qualifications : Experience :
Minimum of 7-10 years of experience in medical insurance / healthcare billing and collections, with at least 5 years in a supervisory or management position.
Strong experience working in a health system or medical practice.
Technical Skills :
Thorough knowledge of CPT, ICD-10, UB-04, HCFA 1500, and HIPAA regulations.
Proficiency in Microsoft Office tools (Word, Outlook, Excel) and other relevant software.
Experience with practice management software and EHR systems is highly desirable.
Soft Skills :
Strong interpersonal skills to effectively relate with the public, patients, organizations, and other employees.
Detail-oriented with the ability to work under pressure and frequent interruptions.
Exceptional problem-solving and analytical abilities.
Keep a pulse on the job market with advanced job matching technology.
If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution.
Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right.
Surveys & Data Sets
What is the career path for a Senior RCM Manager?
Sign up to receive alerts about other jobs on the Senior RCM Manager career path by checking the boxes next to the positions that interest you.
