RCM Operations Manager
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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
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