RCM Manager

Main Duties and Responsibilities

Revenue Cycle Management:

• Develop and implement strategies to optimize the entire revenue cycle, focusing on maximizing revenue generation and minimizing claim denials.
• Oversee all billing, coding, collections, and denial management activities.
• Ensure accurate and timely claim submission to all insurance payers.
• Analyze and identify areas for improvement in the revenue cycle process.
• Manage and monitor key performance indicators (KPIs) such as collection rates, AR days, and denial rates.
• Develop and maintain strong relationships with insurance companies to ensure smooth claim processing and maximize reimbursements.

Credentialing:

• Manage the credentialing process for all dentists within the organization, ensuring timely application submissions and provider enrollment with all necessary insurance companies and healthcare networks.
• Maintain accurate and up-to-date provider information.
• Track credentialing deadlines and proactively manage renewals to avoid disruptions in patient care.
• Negotiate dental fee schedules with insurance companies to secure optimal reimbursement rates for the practice.

Leadership and Team Management:

• Provide strong leadership and direction to the revenue cycle and credentialing teams.
• Develop, coach, and mentor staff to ensure they possess the necessary skills and knowledge to perform their duties effectively.
• Foster a culture of accountability, continuous improvement, and teamwork within the department.
• Implement strategies to mitigate fraud and abuse risks.

Skills and Abilities

• Fluent in English; verbal and written
• Basic computer skills
• Strong interpersonal skills
• Excellent communication, interpersonal, and organizational skills
• Proficient in dental practice management software and relevant revenue cycle management tools
• Ability to work independently and manage multiple priorities simultaneously
• Detail-oriented and results-driven with a focus on accuracy and efficiency
• Proven track record of success in optimizing revenue cycle performance and maximizing collections
• In-depth knowledge of dental coding and billing practices
• Strong understanding of dental insurance and reimbursement processes

Education and Experience

• Minimum 5 years of experience in dental revenue cycle management.
• 2+ years of experience managing and leading a team of revenue cycle and credentialing professionals.
• High school diploma or equivalent required
• College degree preferred

Physical Demands and Work Environment

• This position may be required to sit or stand for long periods
• This position may be required to work more than 40 hours per week
• This position is in a clinical studio environment which can be noisy and distracting
• This position may be exposed to infectious diseases and/or blood borne pathogens
• This position may be required to communicate with others to exchange information
• This position may require repetitive motions that include the wrists, hands and/or fingers
• This position may require the operation of machinery and/or power tools
• This position may require the assessment of the accuracy, neatness and thoroughness of the work assigned
• This position may require moving self in different positions to accomplish tasks in various environments including tight and confined spaces
• This position may require medium work that includes moving objects up to 50 pounds