RCM Manager

This position oversees the RCM team of five remote workers. Our RCM team is responsible for the full revenue cycle: accurately posting insurance and patient payments, adjustments, and denials, while helping ensure clean account balances and efficient revenue flow.

• Monitors staff and department performance.*
• Builds comprehensive A/R financial reports for our management team.*
• Special projects as assigned.*
• Accurately post insurance and patient payments, adjustments, and denials to patient accounts.*
• Review and reconcile Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs).*
• Research and resolve posting discrepancies or missing payments.*
• Communicate with insurance carriers, patients, and internal staff regarding payment issues.*
• Identify and report underpayments, over payments, and recurring payer issues.*
• Claim corrections or resubmissions.*
• Maintain confidentiality and comply with HIPAA and practice policies.*
• Oversee end-of-month reconciliations.*
• Complete claim appeals.*
• Other duties as assigned.

• Minimum 5-7 years’ experience in medical billing at a multi-provider practice.
• Ability to create a positive team work environment.
• Ophthalmology coding experience preferred.
• Familiarity with commercial, Medicare, and Medicaid payer policies.
• Understanding of capitation.
• Ability to identify and help resolve coding or billing discrepancies proactively.
• Experience with healthcare compliance requirements
• Medical Billing and Coding Certification preferred
• High attention to detail and accuracy
• Strong communication and teamwork skills
• Proficient in using EHR/Practice Management systems (experience with Mod Med is a plus)
• Strong organizational and time management abilities