What are the responsibilities and job description for the Revenue Cycle Manager position at Total Ancillary?
RCM Billing Manager
The Revenue Cycle Management (RCM) Billing Manager is responsible for overseeing the billing, claims processing, payment reconciliation, and revenue optimization for the company’s advanced skin substitute products. This role ensures that all billing operations comply with payer regulations, maximize reimbursement, and minimize denials while maintaining efficiency across the revenue cycle. The ideal candidate will have a strong background in medical billing, healthcare reimbursement, and payer relations, particularly within DME, biologics, wound care, or regenerative medicine.
This position requires collaboration with internal stakeholders, including finance, sales, operations, and compliance teams, as well as external payers, providers, and third-party billing vendors.
Specific Responsibilities:
Billing & Revenue Cycle Operations
Oversee the end-to-end medical billing and claims submission process, ensuring accuracy and compliance with payer policies.
Manage charge capture, coding, and claims processing to optimize reimbursement.
Monitor accounts receivable (A/R) performance, identifying trends and implementing corrective actions for outstanding claims.
Ensure timely follow-up on denied and underpaid claims, implementing strategies to reduce denials and increase collections.
Work with internal teams to ensure proper documentation and coding practices to support claims submission.
Payer Relations & Reimbursement Strategy
Ensure compliance with Medicare, Medicaid, and commercial payer policies, as well as federal and state regulations.
Stay updated on industry changes, including CMS updates, payer policy modifications, and coding guidelines (e.g., HCPCS, CPT, ICD-10).
Conduct internal audits and reviews to maintain compliance and minimize billing errors or fraud risks.
Train and educate internal teams on best practices for billing, documentation, and revenue integrity.
Team Leadership & Process Improvement
Manage and mentor a team of billing specialists, coders, and revenue cycle staff, ensuring performance excellence.
Implement best practices and workflow improvements to enhance revenue cycle efficiency and reduce processing times.
Develop standard operating procedures (SOPs) for billing, collections, and denial management.
Utilize RCM software and analytics tools to track KPIs, generate reports, and drive data-driven decision-making.
Qualifications:
Education:
Bachelor’s degree in healthcare administration, finance, business, or a related field preferred.
Certification in Certified Professional Coder (CPC), Certified Revenue Cycle Representative (CRCR), or Certified Healthcare Billing Specialist (CHBS) is preferred.
Experience:
5 years of experience in medical billing, revenue cycle management, or healthcare finance.
Strong knowledge of DME, biologics, wound care, or regenerative medicine billing and reimbursement.
Experience with Medicare, Medicaid, and commercial payer guidelines for medical products and services.
Prior experience managing denials, appeals, and A/R collections in a healthcare setting.
Familiarity with RCM software, EHR/EMR systems, and claims management platforms.
Skills & Competencies:
Strong knowledge of medical coding, reimbursement methodologies, and payer billing guidelines.
Excellent analytical and problem-solving skills, with the ability to interpret complex reimbursement policies.
Effective leadership and team management skills, with the ability to train and mentor billing staff.
Strong attention to detail and organizational skills, ensuring accuracy and compliance in all billing activities.
Proficiency in RCM software, Excel, and reporting tools to track revenue cycle performance.
Work Location:
Dallas or Atlanta. Hybrid or remote work flexibility may be available based on company needs.
Limited travel may be required for payer meetings, industry conferences, or internal training sessions.
Total Ancillary is an Equal Opportunity Employer.All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, or any other legally prohibited criteria.
* Total Ancillary participates in E-Verify*
*NO AGENCIES*