RCM Manager
Job Overview:
We are seeking an experienced and highly organized RCM Manager to oversee and manage the full revenue cycle operations for Primary Care services, including Family Medicine and Internal Medicine in both home visit and outpatient settings. The ideal candidate will also have strong expertise in Transitional Care Management (TCM), Chronic Care Management (CCM), and Durable Medical Equipment (DME) billing and reimbursement processes.
The RCM Manager will be responsible for optimizing billing operations, improving collections, managing denials, ensuring coding and payer compliance, and leading the RCM team to achieve operational and financial goals.
Key ResponsibilitiesRevenue Cycle Operations
- Manage end-to-end revenue cycle functions including:
- Insurance verification
- Charge capture
- Coding review
- Claims submission
- Payment posting
- Accounts receivable follow-up
- Denial management and appeals
- Oversee billing and reimbursement processes for:
- Primary Care
- Family Medicine
- Internal Medicine
- Home Visit Services
- Outpatient Services
- Transitional Care Management (TCM)
- Chronic Care Management (CCM)
- Durable Medical Equipment (DME)
- Ensure timely and accurate claim submission to Medicare, Medicaid, and commercial insurance payers.
- Monitor reimbursement trends and resolve billing discrepancies and denied claims.
Compliance & Coding
- Ensure compliance with CMS, HIPAA, Medicare, Medicaid, and commercial payer regulations.
- Maintain expertise in CPT, ICD-10, and modifier usage relevant to:
- Evaluation & Management (E/M)
- Home visits
- TCM and CCM services
- DME billing
- Outpatient primary care services
- Conduct periodic audits to ensure documentation accuracy and coding compliance.
- Stay updated on payer policy changes and reimbursement guidelines.
Leadership & Team Management
- Supervise and mentor billing, coding, and RCM staff.
- Develop and implement workflows, SOPs, and performance improvement initiatives.
- Monitor team productivity and revenue cycle KPIs.
- Collaborate with providers, clinical teams, and operational leadership to improve revenue cycle efficiency.
Experience Required
- Minimum 6 years of Revenue Cycle Management experience in Primary Care, specifically:
- Family Medicine
- Internal Medicine
- Home Visit and Outpatient Services
- Minimum 3 years of managerial or supervisory experience in healthcare revenue cycle operations.
- Strong hands-on experience with:
- TCM billing
- CCM billing
- DME billing and reimbursement
- Medicare and commercial payer guidelines
Qualifications
- Bachelor’s degree or related field preferred.
- Proficiency in EHR/EMR systems and medical billing software.
- Strong knowledge of CMS regulations and payer compliance requirements.
Required Skills
- Expertise in denial management and payer appeals
- Strong leadership and team management skills
- Strong communication and organizational skills
- High attention to detail and compliance standards
- Ability to manage multiple priorities in a fast-paced healthcare environment
Pay: ₹500,000.03 - ₹1,200,000.25 per year
Benefits:
- Food provided
- Health insurance
Work Location: In person
