RCM Manager

• Manage the complete revenue cycle from patient registration and eligibility verification through billing, claims processing, payment posting, denial management, and collections. • Lead, supervise, and develop the RCM team, including billing, claims, AR, denial, and collection staff. • Monitor daily, weekly, and monthly RCM performance and ensure achievement of operational and financial targets. • Oversee accurate and timely submission of insurance claims. • Monitor outstanding accounts receivable and develop strategies to reduce aging balances. • Analyze and resolve claim denials, rejections, underpayments, and payment discrepancies. • Identify recurring billing and coding issues and coordinate corrective actions with relevant departments. • Maintain effective relationships with insurance companies, TPAs, and other payers. • Review payer contracts, reimbursement terms, and payment trends to identify revenue-impacting issues. • Ensure accurate payment posting, reconciliation, and follow-up on unpaid or partially paid claims. • Develop and implement processes to reduce claim errors, improve clean-claim rates, and accelerate collections. • Prepare and present RCM dashboards and management reports covering KPIs, AR aging, collections, denials, and claims performance. • Establish team KPIs and conduct regular performance reviews. • Coordinate with Finance and Accounting for reconciliation of collections and receivables. • Work with Medical Coding and Clinical teams to address documentation, coding, and billing discrepancies. • Ensure compliance with applicable healthcare regulations, payer requirements, internal policies, and data-protection standards. • Support internal and external audits and ensure timely resolution of audit findings. • Identify opportunities for automation, process improvement, and cost reduction within the revenue cycle. • Escalate significant payer, operational, compliance, or revenue risks to senior management. • Bachelor's degree in Healthcare Management, Finance, Business Administration, Accounting, or a related field. • Professional certification in RCM, medical billing, coding, or healthcare management is an advantage. • 5–8 years of experience in healthcare revenue cycle management, including 2–3 years in a supervisory or managerial role . • Strong knowledge of medical billing, claims processing, denial management, AR follow-up, and payer processes. • Experience working with healthcare providers, insurance companies, and TPAs. • Strong analytical, problem-solving, leadership, and communication skills. • Proficiency in MS Excel and healthcare billing/RCM systems. • Experience with dashboards, KPI reporting, and process improvement.