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