Job Description: RCM Manager (Revenue Cycle Management Manager)
Job Title: RCM Manager
Department: Revenue Cycle Management
Reports To: Director of Operations / VP – Revenue Cycle
Location: [Location]
Employment Type: Full-Time
Job Summary
We are seeking an experienced RCM Manager to lead and oversee end-to-end Revenue Cycle Management operations with strong expertise in Charge Entry, Payment Posting, and Benefits Verification. The ideal candidate will have a proven track record of managing teams, optimizing operational performance, ensuring compliance, and driving revenue enhancement through efficient RCM processes.
Key Responsibilities
- Manage day-to-day operations of the Revenue Cycle Management department.
- Lead and supervise teams handling:
- Charge Entry
- Payment Posting
- Benefits Verification
- Ensure accurate and timely charge capture, coding validation (where applicable), payment posting, and insurance eligibility verification.
- Monitor productivity, quality, turnaround time (TAT), and service-level agreements (SLAs).
- Develop and implement process improvements to enhance operational efficiency and maximize revenue.
- Analyze KPIs, identify revenue leakage, and implement corrective actions.
- Ensure compliance with HIPAA, payer guidelines, and client-specific policies.
- Conduct regular quality audits and provide coaching and performance feedback to team members.
- Collaborate with clients, internal stakeholders, and cross-functional teams to resolve operational issues.
- Prepare daily, weekly, and monthly performance reports for leadership.
- Support recruitment, onboarding, training, and employee development initiatives.
- Handle escalations related to charge entry, payment posting, and benefits verification.
- Drive continuous improvement initiatives through automation and workflow optimization.
Required Qualifications
- Bachelor's degree in Healthcare Administration, Business Administration, Life Sciences, or a related field.
- 8–12+ years of experience in Healthcare Revenue Cycle Management.
- Minimum 3–5 years of managerial experience leading RCM operations.
- Extensive hands-on experience in:
- Charge Entry
- Payment Posting
- Benefits Verification
- Strong understanding of U.S. healthcare insurance, payer guidelines, and reimbursement processes.
- Experience managing large teams in a healthcare BPO, RCM company, or provider organization.
- Excellent analytical, problem-solving, and decision-making skills.
- Strong communication, leadership, and stakeholder management abilities.
- Proficiency in MS Excel, reporting tools, and healthcare practice management/EHR systems.
Preferred Qualifications
- Experience with multiple specialties (e.g., Primary Care, Behavioral Health, Cardiology, Orthopedics).
- Knowledge of medical coding concepts (ICD-10, CPT, HCPCS).
- Experience with denial management and accounts receivable processes is an added advantage.
- Lean Six Sigma or process improvement certification is preferred.
Key Skills
- Revenue Cycle Management (RCM)
- Charge Entry
- Payment Posting
- Benefits Verification
- Team Leadership
- Operational Management
- Process Improvement
- KPI & SLA Management
- Quality Assurance
- Revenue Optimization
- Client Relationship Management
- HIPAA Compliance
- Root Cause Analysis
- Performance Management
- Advanced Microsoft Excel
- Healthcare Operations
Key Performance Indicators (KPIs)
- Charge Entry Accuracy and Productivity
- Payment Posting Accuracy and TAT
- Benefits Verification Accuracy and First-Pass Rate
- SLA Compliance
- Team Productivity and Utilization
- Quality Scores
- Revenue Leakage Reduction
- Employee Engagement and Retention
- Client Satisfaction
- Process Improvement Initiatives
Experience: 8–12+ years in Revenue Cycle Management, with significant experience in Charge Entry, Payment Posting, and Benefits Verification, including at least 3–5 years in a people management role.
Notice Period: Immediate to 30 days preferred (optional, based on hiring requirements)
Pay: ₹691,370.67 - ₹1,200,000.00 per year
Work Location: In person
