RCM Behavioral Health Back-End Manager

Medusind is a leading provider of revenue cycle management solutions to dental, behavioral health, anesthesia, pathology, emergency, surgery, radiology, and other specialties. In January 2023, Alpine Investors, a people-driven private equity firm, invested in Medusind to continue to advance its leadership position as one of the top revenue cycle management companies in the country.

Position Overview:

The Behavioral Health Back-End Manager is responsible for overseeing the day-to-day revenue cycle management (RCM) operations of the AR and Posting departments, within the Behavioral Health division. This role ensures efficiency, compliance, and accuracy in claims processing (AR), denials management, and payment posting operations. The Back-End Manager collaborates with Front-End Manager to streamline workflows, improve financial performance, achieve accuracy, and maintain regulatory compliance in alignment with industry best practices.

Key Responsibilities:

• Strategic Planning & Execution: Oversee back-end behavioral health RCM processes, including AR processes, denials management, appeals, payment posting, and ancillary specialties. Understand, develop and implement SOPs to optimize operational efficiency and minimize revenue leakage.
• Cost Reduction Initiatives: Identify trends in denials and rejections, implementing corrective actions to maximize revenue recovery.
• Weekly/Monthly Reporting: Monitor key performance indicators (KPIs) and drive improvements in cash flow, collections, and reimbursement rates. Understand and conduct root cause analysis to achieve benchmarking on underperforming KPI.
• Technical Skills: Assist in technology implementation and automation initiatives to enhance efficiency and reduce manual errors.
• Collaboration & Communication: Collaborate with cross-functional teams, including front-end operations, finance, and compliance, to resolve billing issues and improve workflows.
• Team Leadership & Development: Lead and motivate teams to achieve performance goals, foster a collaborative environment, and ensure clear communication across all levels. Provide effective feedback and manage relationships with internal and external stakeholders through strong negotiation and public speaking skills. Develop and deliver facility onboarding and adhoc trainings.
• Regulatory Compliance: Keep up with industry trends, regulatory changes, and payer policies. Ensure compliance with payer policies, state and federal regulations, and HIPAA Part 2 requirements.
• Operational & Organizational Management – Prioritize and delegate tasks effectively, ensuring smooth project execution and alignment with organizational goals. Develop and mentor employees, optimizing team strengths to improve efficiency and outcomes.
• Problem-Solving & Strategic Decision-Making – Analyze issues logically, think strategically to enhance operations, and make confident decisions under pressure to drive continuous improvement.
• Client Relationship Management: Maintain relationships with insurance payers to address claim resolution, escalations and reimbursement challenges. Utilize data analysis and reporting tools to provide insights and recommendations for process improvements.

• Educational Background: Bachelor’s degree in healthcare administration, Business, Finance, or a related field.
• Experience: At least three years of experience in healthcare back-end revenue cycle management functions, billing, or insurance claims processing, with a focus on behavioral health. Strong leadership, communication, and problem-solving skills.
• Expert Industry Knowledge: Strong knowledge of commercial payers, Medicaid, and Medicare guidelines, and regulatory compliance. Navigating insurance change, driving innovation, and implementing process improvements.
• Analytical & Strategic Thinking: Ability to identify and resolve gaps in process, including payment reconciliation.
• Cost Reduction Initiatives: Understanding financial reports, budgeting, and resource allocation. Cost control, financial forecasting, and optimizing revenue cycle.
• Communication & Collaboration: Strong ability to collaborate with cross-functional teams, including finance, clinical operations, and IT, to align revenue cycle management strategies with the organization’s broader goals.
• Client Relationship Management: Exceptional customer service skills and ability to cultivate strong relationships with clients to ensure satisfaction and retention.
• Customer service skills: Strong customer service skills to manage relationships with clients, including communicating with them to resolve service delivery issues and promote client satisfaction.
• Detail-Oriented: Ability to set and maintain priorities in a fast-paced environment, with multiple demands and interruptions.
• Collaborative Problem Solving: Ability to work and communicate effectively with a diverse group of people including other department managers, staff, physicians, patients, and the client.
• Technical skills: Experience with billing software, data analytics, and process improvement initiatives. Leveraging technology and automation to enhance efficiency and accuracy.
• Adaptability and flexibility: Should be able to adapt to changes in regulations, technologies, and industry trends and adjust the revenue cycle management strategy accordingly.
• Team Development: Skilled in recruiting, mentoring, and leading high-performing teams to achieve or surpass performance objectives.
• Performance Management: Ability to monitor team performance and make adjustments as needed to improve team and individual performance.
• Team Building: Ability to build and lead a high-performing team that is capable of meeting or exceeding performance goals.