- Location
- Las Vegas, NV
- Type
- Full-time
- Department
- Sales
- Seniority
- Senior
- Education
- Bachelor
- Source
- ApplicantPro
Description
Position Summary:
The RCM Manager oversees the full healthcare revenue cycle process, including billing, claims processing, collections, denial management, and accounts receivable management to ensure maximum reimbursement and operational efficiency. This role leads RCM teams, monitors financial and performance metrics, ensures compliance with healthcare regulations, and implements process improvements to optimize revenue and reduce claim denials. The RCM Manager also collaborates with providers, insurance companies, and finance leadership to resolve billing issues, improve workflows, and support organizational growth.
Key Responsibilities:
Revenue Cycle Operations
- Oversee end-to-end revenue cycle operations from patient registration to final payment collection.
- Ensure timely and accurate claim submission to insurance payers.
- Monitor billing workflows, payment posting, and collections activities.
- Develop and implement strategies to reduce claim denials and improve cash flow.
- Analyze aging reports and resolve outstanding accounts receivable issues.
Team Leadership
- Supervise RCM staff including billing specialists, coders, collectors, and insurance verification
teams.
- Conduct performance evaluations and provide coaching/training.
- Establish departmental KPIs and productivity standards.
- Foster a culture of accountability and continuous improvement.
Compliance & Quality Assurance
- Ensure compliance with HIPAA, CMS guidelines, payer requirements, and healthcare regulations.
- Maintain accurate documentation and audit readiness.
- Monitor coding and billing accuracy to minimize compliance risks.
Financial Management
- Prepare revenue cycle performance reports and dashboards.
- Track metrics such as:
o Days in AR
o Clean claim rate
o Denial rate
o Net collection ratio
o Cash collections
- Collaborate with finance leadership on revenue forecasting and budgeting.
Process Improvement
- Identify operational inefficiencies and recommend workflow enhancements.
- Implement automation and process optimization initiatives.
- Coordinate with EMR/EHR and billing system vendors when needed.
Client & Stakeholder Communication
- Collaborate with providers, clinic managers, insurance companies, and external partners.
- Escalate and resolve complex billing or payer issues.
- Support organizational growth initiatives and payer contract management.
Qualifications:
- Bachelor's degree in Healthcare Administration, Business Administration, Finance, or
related field.
- 5–7+ years of healthcare revenue cycle management experience.
- Strong understanding of healthcare revenue cycle processes (front, middle, and back-
office operations)
- Proven experience in leading teams and managing client-facing engagements
- Familiarity with healthcare systems, workflows, and automation tools is an advantage
- Strong leadership, coaching, and stakeholder management skills
- Excellent interpersonal and communication (written & verbal) skills
- Can start immediately, if possible
Strong knowledge of:
- Medical billing and coding
- Insurance verification
- Prior authorization
- Denial management
- Medicare/Medicaid regulations
Skills & Competencies
- Strong analytical and problem-solving skills
- Excellent leadership and communication abilities
- Knowledge of EMR/EHR and practice management systems
- Advanced Excel/reporting skills
- Attention to detail and organizational skills
- Ability to manage multiple priorities in a fast-paced environment.
