RCM Supervisor

Essential Duties and Responsibilities

• Supervise and support a team of billing specialists, A/R representatives, payment posters, and denial management staff.
• Monitor productivity, quality, and performance against established KPIs.
• Cook off employee coaching, training, and performance evaluations.
• Assist with recruiting, onboarding, and staff development initiatives.
• Foster a culture of accountability, customer service, and continuous improvement.
• Oversee end-to-end revenue cycle processes for assigned physician practice clients.
• Ensure timely claim submission and resolution of claim edits and rejections.
• Maintain insurance follow-up activities and collection efforts.
• Review and manage aged accounts receivable and work queues.
• Ensure accurate payment posting, adjustments, and reconciliation activities.
• Oversee denial management and appeals processes to maximize reimbursement.
• Escalate payer issues and identify reimbursement trends affecting client revenue.
• Serve as the primary operational contact for assigned client accounts.
• Participate in regular client meetings to review financial performance and operational metrics.
• Present reports on collections, A/R aging, denial trends, and revenue opportunities.
• Address client concerns and develop action plans to improve performance.
• Collaborate with providers and practice managers to resolve workflow and documentation issues impacting reimbursement.

Performance Management & Reporting

• Monitor and analyze key performance indicators, including:
• Days in Accounts Receivable (A/R)
• Net Collection Rate
• Gross Collection Rate
• First-Pass Resolution Rate
• Clean Claim Rate
• Denial Rate
• Aging Over 90 and 120 Days
• Charge Lag
• Payment Posting Turnaround Time
• Prepare and distribute operational and financial reports to management and clients.
• Identify revenue leakage and recommend corrective actions.

Compliance & Quality Assurance

• Ensure compliance with HIPAA, payer regulations, and billing guidelines.
• Maintain adherence to Medicare, Medicaid, and commercial payer requirements.
• Conduct quality audits of claims, payment posting, and collection activities.
• Maintain documentation and process standards required for client contracts and audits.

Process Improvement

• Identify workflow inefficiencies and implement best practices.
• Collaborate with coding, credentialing, and implementation teams to improve revenue cycle outcomes.
• Support system enhancements, software implementations, and automation initiatives.
• Develop standard operating procedures (SOPs) and training materials.

Qualifications

• Education: Associate's degree required; Bachelor's degree in Healthcare Administration, Business Administration, Finance, or related field preferred.
• Experience: Minimum 5 years of medical billing and revenue cycle management experience; minimum 2 years of supervisory or team leadership experience; experience managing multi-specialty physician practice accounts preferred; experience working for a medical billing company, RCM vendor, or physician management organization strongly preferred.
• Knowledge & Skills: Comprehensive knowledge of physician billing and revenue cycle operations; strong understanding of CPT, ICD-10, HCPCS, and payer reimbursement methodologies; experience with Medicare, Medicaid, commercial insurance, and managed care plans; proficiency with practice management systems and EHR platforms; advanced Excel and reporting skills; strong analytical, organizational, and client-facing communication abilities; ability to manage multiple client accounts simultaneously.
• Preferred Certifications: Certified Revenue Cycle Representative (CRCR); Certified Professional Biller (CPB); Certified Professional Coder (CPC).