RCM Manager- Oral Surgery
- Develop, implement, and oversee comprehensive revenue cycle strategies aligned with organizational goals and high-growth objectives.
- Identify, evaluate, and help implement automation technologies and solutions (e.g., RPA, AI-driven claim scrubbing, automated denial management) to enhance RCM efficiency, accuracy, and scalability.
- Champion process re-engineering efforts to streamline workflows, reduce manual intervention, and accelerate cash flow.
- Continuously analyze RCM performance metrics (e.g., A/R days, denial rates, clean claim rate, collection rates) to identify trends, root causes of issues, and opportunities for improvement.
- Lead cross-functional initiatives to optimize all stages of the revenue cycle, including insurance verification, claims submission, payment posting, denials management, and collections.
- Develop and implement best practices, policies, and procedures to ensure compliance, maximize reimbursement, and minimize revenue leakage.
- Manage, mentor, and develop a high-performing RCM team, fostering a culture of accountability, continuous learning, and excellence.
- Promote strong collaboration between RCM, operations, integrations, finance, and other departments to ensure seamless information flow and alignment on revenue cycle goals.
- Conduct regular team meetings, performance reviews, and provide constructive feedback to support professional growth.
- Establish and monitor key performance indicators (KPIs) and service level agreements (SLAs) for all RCM functions.
- Prepare and present detailed RCM performance reports to senior leadership, highlighting achievements, challenges, and strategic recommendations.
- Forecast revenue trends and potential risks, proactively developing mitigation strategies.
- Ensure strict adherence to all relevant healthcare regulations, payer requirements, HIPAA, and other compliance standards.
- Oversee and conduct audits related to billing and collections, implementing corrective actions as needed.
- Manage relationships with third-party RCM vendors, billing services, and technology providers to ensure optimal performance and cost effectiveness through SLA’s and quality audits.
- Bachelor's degree required. Preferred fields include Healthcare Administration, Business Administration, Finance, or related discipline.
- Oral Surgery management experience is required.
- Minimum of 3 years of progressive leadership experience in Revenue Cycle Management within a healthcare setting.
- Experience managing RCM for large healthcare providers with 30+ locations or providers a strong plus.
- Demonstrated expertise in implementing and optimizing RCM automation tools and technologies.
- Proven track record of driving significant process improvements and achieving measurable results in RCM performance.
- Experience in a high-growth environment is highly desirable.]
- Coding certification is a strong plus but not required.
- Exceptional analytical and problem-solving skills with the ability to interpret complex financial data and trends.
- Strong understanding of healthcare billing, coding (CPT, ICD-10, HCPCS), claims submission, denial management, and collection processes.
- Proficiency with various RCM software, EHR/EMR systems and data analytics tools.
- Excellent leadership, communication (written and verbal), and interpersonal skills.
- Ability to work collaboratively across departments and influence stakeholders at all levels.
- Highly organized, detail-oriented, and able to manage multiple priorities in a fast-paced, evolving environment.
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