Revenue Cycle Manager

Job description

Role & responsibilities • Manage and oversee all revenue cycle operations, including patient registration, insurance verification, medical coding, billing, claims processing, collections, and payment reconciliation. • Ensure accurate and timely submission of insurance and patient claims. • Monitor accounts receivable (AR) and reduce outstanding balances through effective follow-up. • Lead denial management activities by identifying root causes and implementing corrective actions. • Improve clean claim rates and reduce claim rejections. • Coordinate with clinical, finance, coding, and insurance teams to resolve billing issues. • Develop and implement revenue cycle policies, procedures, and best practices. • Monitor key performance indicators (KPIs) such as Days in AR, Collection Ratio, Claim Acceptance Rate, Denial Rate, and Cash Collections. • Ensure compliance with hospital policies, payer requirements, and applicable healthcare regulations. • Conduct regular audits of billing, coding, and reimbursement processes. • Prepare monthly revenue cycle reports and present performance metrics to senior management. • Manage relationships with insurance companies, TPAs, government health schemes, and other payers. • Train, mentor, and evaluate the performance of the RCM team. • Identify opportunities for automation and process improvement to increase operational efficiency. • Support budgeting, forecasting, and financial planning related to revenue cycle operations. Preferred candidate profile • Strong knowledge of hospital billing, medical coding (ICD-10, CPT, HCPCS), and insurance claim processes. • Knowledge of government and private insurance reimbursement policies. • Excellent analytical and financial reporting skills. • Strong leadership and team management abilities. • Excellent communication, negotiation, and interpersonal skills. • Advanced proficiency in Microsoft Excel and healthcare management systems. • Ability to manage multiple priorities and meet deadlines