Jobs · OTHR · Florida

RCM Supervisor

ProMD Medical Billing · Miami, FL · 1 mo ago
On-siteOTHRFull-time

Position Summary

The RCM Supervisor is responsible for overseeing daily revenue cycle operations for a portfolio of independent physician practices served by the company. This role supervises billing, collections, payment posting, denial management, and accounts receivable teams to ensure clients achieve optimal reimbursement, reduced A/R days, and high clean-claim rates. The RCM Supervisor serves as a key liaison between clients, payers, providers, and internal teams, ensuring service excellence and compliance with industry regulations.

Essential Duties And Responsibilities

Team Leadership

  • 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.
  • Conduct employee coaching, training, and performance evaluations.
  • Assist with recruiting, onboarding, and staff development initiatives.
  • Foster a culture of accountability, customer service, and continuous improvement.

Revenue Cycle Operations

  • Oversee end-to-end revenue cycle processes for assigned physician practice clients.
  • Ensure timely claim submission and resolution of claim edits and rejections.
  • Monitor 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.

Client Relationship Management

  • Serve as the primary operational contact for assigned client accounts.
  • Participates 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.
  • Monitor 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)

Key Success Metrics

  • Achieve or exceed client collection goals.
  • Maintain A/R days within target benchmarks.
  • Improve first-pass claim acceptance rates.
  • Reduce denial volumes and aged receivables.
  • Meet client service level agreements (SLAs).
  • Maintain high client satisfaction and retention rates.
  • Achieve team productivity and quality standards.

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