RCM Success Manager

ESSENTIAL FUNCTIONS

- Serve as the primary RCM strategic partner for assigned markets and physician groups
• Monitor and analyze key performance indicators including charge lag, denial rates, AR aging, AR >90 days, and net collection rate
• Lead monthly and quarterly revenue cycle reviews with market leadership and providers
• Identify root causes of revenue leakage and assist in developing corrective action plans
• Drive reduction in controllable denials through payer-specific analysis and operational collaboration
• Partner with cross-functionally with key revenue cycle stakeholders to proactively identify and resolve issues impacting revenue integrity and reimbursement performance.
• Support new market onboarding and RCM ASA integrations
• Escalate systemic issues to executive leadership with proposed solutions
• Participate in cross-functional revenue cycle initiatives and performance improvement projects

EDUCATION

Preferred:
• BA or BS Degree

- CPC, CPB, CRCR, or other revenue cycle certification preferred

EXPERIENCE

- Minimum 5–7 years of progressive experience in healthcare revenue cycle management
• Experience working with physician practices, ambulatory surgery centers, or musculoskeletal service lines preferred
• Demonstrated experience analyzing financial and operational performance metrics
• Experience leading cross-functional initiatives and presenting to executive leadership

REQUIREMENTS

- Ability to travel periodically to assigned markets
• Strong understanding of payer reimbursement methodologies including Medicare Advantage, Commercial, Medicaid, and Workers’ Compensation
• Advanced proficiency in Microsoft Excel and reporting tools
• Ability to manage multiple markets and priorities simultaneously

KNOWLEDGE

- Revenue cycle workflows from front-end through denial resolution and collections
• CPT/HCPCS coding fundamentals and modifier usage
• Accounts receivable management strategies
• Regulatory compliance related to revenue cycle operations

SKILLS

- Advanced analytical and financial interpretation skills
• Executive-level presentation and communication skills
• Strong problem-solving and critical-thinking abilities
• Data visualization and dashboard development
• Cross-functional collaboration and relationship management
• Project management and organizational skills

ABILITIES

- Ability to translate complex financial data into actionable insights
• Ability to build trust with providers and operational leaders
• Ability to prioritize high-impact initiatives in fast-paced environments

ENVIRONMENTAL WORKING CONDITIONS

- Remote work environment

• Periodic travel to practice locations

- Frequent computer use and virtual meeting participation

Originally posted on Himalayas