Position: RCM Manager

Classification: Exempt

Position Status:  Full-Time

Reports to: Director of Billing Operations/CEO

Hours:  Days and hours of work are Monday through Friday, 8:00 a.m. to 5:00 p.m.

Position Summary
The RCM Manager is responsible for the management and administration of daily operations for the billing department to include coordinating, planning, and facilitating activities necessary for the efficient operations of the billing department and billing staff.

Essential Functions

  • Create and maintain a harmonious work environment through positive communication, feedback, mentoring, and coaching.          
  • Oversees all operations within the billing department
  • Ensures the workflow reaches maximum efficiency and productivity
  • Point of contact for handling escalations and employee performance issues that impact the operations.
  • Develop and deliver performance reviews, corrective actions, or counseling for staff
  • Generate, interpret and analyze productivity reports to improve workflow, team performance, and customer satisfaction.
  • Act as Subject Matter Expert (SME) for employee questions.
  • Perform regular quality assurance audits on staff/functions within the billing department and meeting one on one with staff routinely to review results and provide feedback.
  • Support of internal and external auditors
  • Morning Huddles with staff to establish key goals for the day, week, month
  • Proactive identification of simplification / automation opportunities
  • Organization and active involvement in the training of new hires
  • Demonstrate the ability to train effectively and cater to individual training needs
  • Proactively manage and ensure compliance with control objectives
  • Management of attendance and time-off requests to ensure adequate staffing at all times.
  • Implement action plans to enhance customer experience and team performance.                                                                                                                         • Monitor individual and team performance and identify and act on both positive and negative performance trends.
  • Keep corporation abreast of performance trends or concerns that impact operations.
  • Be willing to perform all tasks within the team when necessary.
  • Maintain an appropriate work environment and cleanliness of facility.
  • Provide communication and training to ensure staff are fully informed of all new processes and procedures, customer needs, and company related issues.’Recognize individual and team achievements.
  • Generate financial reports on weekly and monthly basis as necessary, and report to executive team on concerns, trends, and the overall financial health of the company
  • Communication and training with provider team on billing and coding information
  • Performing routine audits on medical records to ensure accuracy with billing and coding requirements
  • ‘Meeting with provider team to review productivity reports and areas of opportunity
  • Maintain compliance with OIG, CMS and other insurance payer policies.
  • Creation and maintenance of company dashboards track and monitor financial data and productivity
  • Maintain benchmarks for key performance indicators as established for optimal efficiency within the department’
  • Creating, maintaining and updating department’s standard operating procedures as needed
  • Working cohesively with other departments (front office and clinical) to ensure company wide efficiencies and compliance
  • Credentialing of new providers and maintenance of existing providers’ credentialing status via CAQH and/or other payer specific methods
  • Contracting with new insurance payers and/or negotiation of fee schedules
  • Handling of EMR/IT support tickets for the billing department

Competencies

  • Knowledge of the complete revenue cycle management model.
  • Cross-trained in the essential functions of a Billing Specialist, including Charge Entry, Posting of Insurance and Patient Payments, Clearinghouse and EDI management, Accounts Receivables and Denial Management.
  • Cross-trained in the essential functions of an Insurance Specialist, including verifications and authorizations.
  • Strong understanding of medical coding.
  • Strong organizational and people management skills.
  • Solid attention to detail to ensure accuracy of information.
  • Excellent computer skills, including Word, Excel, and Google Drive.
  • Ability to present, communicate initiative, results, and analyses to multiple levels of management.

Supervisory Responsibility
This position has supervisory responsibilities.

Work Environment
This job operates in a professional, clinical office environment. This role routinely uses standard office equipment such as computers, phones/headsets, photocopiers, filing cabinets, and fax machines.  

Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, stand, walk; use hands to finger, handle or feel; and reach with hands and arms. This position may require sitting for long periods of time during shift.

Travel
This position may require employee to travel between clinic locations.

Required Education and Experience 

  • Bachelor’s degree in relevant field or an equivalent combination of education, training and experience.
  • 2 years of successful, progressive supervisory experience within a medical billing setting
  • 2 years of EMR experience.
  • CPC Certification

Additional Eligibility Qualifications

  • None

Other Duties      

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.  Duties, responsibilities, and activities may change at any time with or without notice.