RCM Operations Manager

About the role

We are seeking an experienced and results-driven RCM Operations Manager to lead and optimize our Revenue Cycle Management operations. The ideal candidate will oversee end-to-end RCM functions, drive operational excellence, ensure key performance metrics are met, and lead high-performing teams responsible for maximizing revenue collection and maintaining compliance with healthcare regulations.

Key responsibilities

• Manage daily operations of the Revenue Cycle Management department
• Lead and develop RCM supervisors, team leads, and staff to achieve operational goals
• Monitor and improve key performance indicators (KPIs), including clean claim rate, first-pass resolution rate, days in A/R, denial rate, collection rate, and authorization turnaround times
• Identify operational bottlenecks and implement process improvements
• Develop strategies to maximize reimbursement and reduce claim denials
• Collaborate with clients, providers, payers, and cross-functional teams to resolve escalated revenue cycle issues
• Ensure compliance with HIPAA, payer regulations, and company policies
• Analyze operational reports and present insights and recommendations to senior leadership
• Support workforce planning, forecasting, and resource allocation
• Lead training, coaching, and performance management initiatives

About you

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field
• Minimum of 5 years of leadership experience in Revenue Cycle Management
• Strong knowledge of insurance verification, prior authorization, medical billing, claims processing, accounts receivable management, denial management, and payment posting
• Experience managing large operational teams in a healthcare or RCM environment
• Strong analytical and reporting skills
• Excellent communication and stakeholder management abilities
• Proficiency in healthcare practice management systems, EMR/EHR platforms, and reporting tools
• Advanced Microsoft Excel and data analysis skills
• Preferred: CPC, CPB, CRCR, or other relevant healthcare certifications