RCM Operations Manager - ZipRecruiter : Job Details

Job Description

Job Profile

Job Title: Revenue Cycle Management (RCM) Operations Manager

Location: Buffalo, NY

Hire Type: Direct Hire

Pay Range: $80,000-$110,000

Work Model: Hybrid

Recruiter Contact: Amy Dugenske, 716-###-####, [email protected]

Nature & Scope

Positional Overview: Are you an experienced RCM professional eager to take on a leadership role within a growing billing company backed by the largest healthcare organization in Western New York? We're seeking a dynamic individual with deep expertise in the full revenue cycle, including a strong understanding of denials management and payer requirements.

The Revenue Cycle Management (RCM) Operations Manager will oversee the daily operations of the revenue cycle team—encompassing billing, coding, charge entry, payment posting, accounts receivable, and denial management. This role ensures alignment with the organization's goals for financial performance, regulatory compliance, and patient satisfaction. The manager is also responsible for guiding and developing staff, driving process improvements, and ensuring compliance with payer and regulatory standards.

Role & ResponsibilitiesLeadership Team Functions

• Supervises and mentors a team of billing and coding professionals, providing ongoing training, performance evaluations, and professional development.
• Identifies and addresses workflow inefficiencies and implements best practices to improve revenue cycle performance.
• Fosters a culture of continuous improvement and innovation.
• Acts as a staff resource and role model for ethical, professional conduct.
• Participates in the hiring process.
• Delegates duties and projects to appropriate staff, and monitors for accurate and prompt completion.
• Stays informed of all relevant regulations, standards, and directives from regulatory agencies and third-party payers.
• Stays updated on changing healthcare trends and leverages technology and automation to develop and deliver new products and services to customers.
• Demonstrates knowledge of safety policies and procedures, and actively maintains a safe and positive work environment.

Role Specific Functions

• Oversees all functions of the revenue cycle, including patient registration, charge capture, billing, collections, denials, and cash posting.
• Monitors daily operations and key performance indicators (KPIs) to ensure productivity, accuracy, and timely processing of claims.
• Ensures compliance with payer rules, HIPAA regulations, and federal/state billing laws.
• Collaborates with clinical, administrative, and IT teams to resolve billing or documentation discrepancies.
• Manages denial trends and coordinates appeals processes to minimize lost revenue.
• Analyzes revenue cycle data to identify trends, issues, and opportunities for improvement; prepares regular reports for leadership.
• Participates in payer contract reviews and schedule maintenance as needed.
• Supports audits, both internal and external, and ensures accurate recordkeeping and documentation.
• Leads and participates in system upgrades or software transitions related to revenue cycle systems (e.g., EMR/EHR, clearinghouses).

Skills & ExperienceQualifications That Will Help You Thrive

• Minimum of 5 years of progressive experience in medical billing and revenue cycle management, with at least 2 years in a supervisory or management role.
• Proven leadership experience managing teams and driving change initiatives in a complex environment.
• In-depth knowledge of coding (ICD-10, CPT, HCPCS), payer reimbursement rules, and medical billing regulations.
• Bachelor's degree in Business Administration, Engineering, Operations Management, or a related field is preferred.
• Strong analytical skills with the ability to interpret and act on financial data.
• Experience with EMR/EHR systems and revenue cycle software (e.g., Epic, Cerner, Medent, Athena).
• Excellent leadership, organizational, and communication skills.
• Ability to work independently and collaboratively in a fast-paced environment.
• Exemplary problem-solving and conflict-resolution skills.
• Detail-oriented.
• Skilled in synthesizing a wealth of information.
• Exhibits excellent time management and prioritization abilities.
• Capable of following and providing detailed instructions both orally and in writing.
• Extensive experience working with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, Access, Project).

#J-18808-Ljbffr