Revenue Cycle Manager, Client Performance

Company Overview

TRIARQ Health partners with physicians by providing the expertise, services, infrastructure, and technologies necessary for independent doctors to thrive in the new, value‑based healthcare economy. We strive to achieve healthcare’s Triple Aim through provider‑led and patient‑centered, value‑based care programs and alliances. TRIARQ Health aims to align and address the value and quality of healthcare to consumers through value‑based programming with payers and providers. Our community of healthcare professionals and providers combine their expertise and capabilities to offer unique value‑based, technology‑enabled services to individuals and families. We believe the future of healthcare services must be based upon demonstrated value and quality, centered on the Triple Aim of high‑quality, affordable care by aligning incentives and redesigning care delivery around quality.

Position Overview

The RCM Client Success Manager is responsible for managing and maintaining strong relationships with practices and internal RCM leadership teams. The role oversees billing team performance to ensure post‑sale goals are met, combining revenue cycle management and client success responsibilities to optimize performance and satisfaction. This position is critical to the success of the revenue cycle process, contributing to day‑to‑day operations, identifying trends, implementing process improvements, and monitoring key performance indicators. The role requires analytical work with raw claim‑level data, independent research of payer policy and CMS guidance, and building analyses without relying solely on pre‑built reporting. The ideal candidate has extensive healthcare industry knowledge, deep RCM experience, strong analytical capability, command of payer and regulatory policy, excellent communication skills, and self‑motivation.

Responsibilities

• Develop and implement practice‑specific process improvement recommendations, monitor performance for unfavorable trends, and maintain reimbursement‑related KPIs such as Days in A/R, outstanding receivables, and first pass rate.
• Enhance and standardize workflow processes throughout the revenue cycle to achieve consistency with standard operating procedures and ensure billing team performance meets post‑sale goals and service commitments.
• Analyze claim‑level and charge‑level data to identify root causes of denials, payment variance, underpayment, and A/R aging concentration; translate findings into corrective actions.
• Interpret revenue cycle KPIs and other performance indicators to pinpoint successes and opportunities; produce monthly reports and PowerPoint presentations for forecasting.
• Provide written executive summaries, presentations, and key information to physicians and administrators.
• Research and interpret payer medical policy, coverage determinations, coding edits, and CMS guidance (including NCCI edits, LCDs, NCDs, and fee‑schedule updates) to resolve denial trends.
• Monitor payer behavior and industry trends, advise practices and internal teams on operational impact, and translate findings into defensible written positions for appeals and client communication.
• Own customer satisfaction for assigned accounts, build and maintain effective internal and external relationships, conduct strategic planning and performance review sessions, and map business goals to value‑driver frameworks.
• Demonstrate knowledge of TRIARQ software and services, act as a problem solver and client advocate, identify at‑risk clients proactively, and collaborate across operational lines to pursue solutions.

Experience and Education

• Minimum of five (5) years of medical billing management experience.
• Bachelor’s degree in healthcare administration, business, or a related field, or equivalent experience.

Analytical and Technical Skills

• Advanced Excel proficiency required, including pivot tables, lookup functions, and the ability to build analysis from raw, unformatted data exports.
• Demonstrated ability to work with large claim‑level datasets to identify root causes of denials, payment variance, and A/R trends.
• Ability to analyze financial and operating information to facilitate decision‑making.
• Strong working knowledge of Microsoft Word, Excel, and PowerPoint.
• Comfort using AI tools to accelerate analysis, reporting, and documentation workflows preferred.

Payer and Regulatory Knowledge

• Ability to independently research and apply payer policy and CMS guidance, including NCCI edits, LCDs, NCDs, coverage criteria, and fee‑schedule methodology.
• Working knowledge of denial and remittance code sets (CARC/RARC) and ability to connect denial patterns to underlying payer policy or edit changes.
• Ability to monitor and interpret payer and regulatory trends and communicate operational implications to non‑technical audiences.

Professional Skills

• Exceptional interpersonal skills with strong oral and written communication abilities.
• Relationship management and negotiation skills.
• Ability to prioritize and manage multiple projects in a dynamic work environment.
• Project management and coordination experience.
• Excellent problem‑solving skills and strong attention to detail.
• Ability to work independently and collaboratively with a multidisciplinary team.