RCM Manager

Position Overview

We are seeking an experienced Revenue Cycle Management (RCM) Manager to lead and optimize the end-to-end revenue cycle operations for a rapidly growing in-home healthcare and community-based services organization. This contract position will play a critical role in managing claims processing, denials, reimbursement performance, payer relationships, and revenue cycle analytics while leading both domestic and offshore teams.

Key Responsibilities

• Lead all aspects of Revenue Cycle Management (RCM), including claim submission, clearinghouse management, denial resolution, and reimbursement optimization.

• Oversee and mentor a team of RCM analysts as well as offshore revenue cycle and billing teams, ensuring performance, accountability, and workflow efficiency.

• Manage relationships with clearinghouses, payers, and internal stakeholders to resolve billing issues and accelerate cash collections.

• Monitor, analyze, and report on key revenue cycle metrics, including denial rates, collections, aging, and reimbursement trends.

• Develop dashboards and reporting tools using Excel, Power BI, and other business intelligence platforms.

• Partner with Finance, Operations, and Clinical teams to identify process improvement opportunities and reduce claim denials.

• Ensure accuracy of contract rates, reimbursement schedules, wage updates, and payer configurations.

• Maintain compliance with Federal, State, County, Medicare, Medicaid, and payer regulations.

• Support system implementations, acquisitions, and integration projects related to billing and revenue cycle functions.

• Oversee payer enrollment processes and management of payer portals.

• Drive continuous improvement initiatives to enhance operational scalability and revenue performance.

Required Qualifications

• Bachelor's degree in Finance, Accounting, Healthcare Administration, or related field.

• 8+ years of progressive Revenue Cycle Management experience.

• 5+ years of experience within home healthcare, home care, HCBS, or related healthcare services organizations.

• Strong understanding of medical billing, claims processing, and reimbursement methodologies.

• Knowledge of CPT, HCPCS, and ICD-10 coding principles.

• Experience managing multi-site healthcare operations.

• Demonstrated success leading offshore and international teams, including workflow management and performance oversight across global resources.

• Experience billing for home care services such as Personal Assistance, Social Recreation, Family Management Services (FMS), or related programs.

• Strong knowledge of healthcare regulations, compliance requirements, HIPAA, and payer guidelines.

• Advanced Excel skills, including complex modeling and VBA automation.

• Experience with Power BI, SQL, and revenue cycle reporting tools.

Ideal Candidate Profile

Proven leader with extensive in-home healthcare revenue cycle management experience.
Strong analytical and problem-solving capabilities.
Comfortable managing teams across multiple locations and time zones, including overseas/offshore staff.
Process-improvement oriented with a focus on increasing collections and minimizing denials.
Effective communicator able to collaborate across Finance, Operations, Clinical, and Executive leadership teams.