Manager – RCM Project

This is a fully remote position, open to applicants in United States.

📋 Description

• Spearhead initiatives for revenue cycle recovery and special projects aimed at minimizing accounts receivable, preventing uncollectible rental billing, addressing CMN and PAR documentation gaps, and recovering revenue through analysis of denials and write-offs.

• Oversee projects from inception to completion, prioritizing tasks based on financial implications and delegating them appropriately.

• Supervise contracted vendor teams executing revenue cycle tasks in Brightree.

• Collaborate with teams from Billing, Collections, Cash Applications, Reimbursement, Patient Access, Intake, Resupply, Confirmation, Brightree System Configuration, and Field Operations.

• Define, plan, and execute worklist-driven cleanup projects related to rental stops, Held A/R, CMN and PAR recovery, denials, unbilled revenue, cash posting, and payer modifications.

• Prioritize tasks based on dollar impact and potential for recovery.

• Establish success metrics for projects and communicate progress and outcomes to revenue cycle leadership.

• Transform project insights into Standard Operating Procedures (SOPs), ongoing processes, system configuration actions, and transitions to functional owners.

• Act as the main point of contact for contracted vendors and Brightree service teams.

• Allocate and transition work queues among internal personnel, vendors, and automation systems.

• Assess vendor productivity and quality against Service Level Agreements (SLAs) and audit vendor activities within Brightree.

• Examine discrepancies between vendor-reported production and the Brightree system-of-record data.

• Lead evaluations of vendor performance and the development of corrective action plans.

• Assist with vendor onboarding, Brightree access setup, workflow training, and coordination of HIPAA-related tasks with IT.

• Suggest work distribution among internal staff, vendors, and automation solutions.

• Collaborate with IT and automation teams to define, test, and supervise bots and automated workflows.

• Create and maintain project trackers, worklists, and dashboards using Brightree, Snowflake, or other reporting tools.

• Analyze data related to Held, stops, denials, and write-offs to pinpoint root causes and opportunities for bulk resolution.

• Work with cross-functional teams to eliminate upstream factors causing Held A/R, stops, and denials.

• Keep documentation of project charters, SOPs, vendor contracts, scorecards, SLAs, and performance review results.

• Ensure adherence to company policies, healthcare regulations, and relevant industry standards.

⛳️ Requirements

• Minimum of 3 years of experience in revenue cycle management, medical billing and collections, or accounts receivable follow-up.

• Preferably experienced in a DME/HME or healthcare environment.

• Proven experience in leading projects, teams, or outsourced resources.

• Hands-on experience with Brightree or a similar healthcare billing and revenue cycle platform.

• Knowledge of rental billing, claims processing, CMN and prior authorization requirements, denials, cash posting, A/R aging, and collections.

• Demonstrated history of executing multi-stakeholder projects leading to measurable financial results.

• Experience in coordinating or managing outsourced or offshore vendor teams.

• Strong analytical capabilities and the ability to navigate large worklists and data sets.

• Advanced skills in Microsoft Excel, including pivot tables, lookups, and reporting functions.

• Proficient in the Microsoft Office Suite.

• Exceptional verbal and written communication abilities.

• Capable of managing multiple projects and competing priorities in a fast-paced environment.

• Preferred: Bachelor's degree in Business Administration, Healthcare Administration, Finance, or a related field.

• Experience in DME/HME rental billing and reimbursement, especially concerning respiratory equipment.

• Familiarity with Snowflake, SQL, or other business intelligence and reporting tools.

• Experience with robotic process automation or workflow automation in a revenue cycle context.

• Understanding of payer-specific billing and collection requirements for Medicare, Medicaid, and commercial payers.

• Experience in developing vendor scorecards, SLAs, or performance improvement plans.

• Training in Lean, Six Sigma, PMP, or other process improvement or project management methodologies.

🏝️ Benefits

• Comprehensive Medical, Dental, and Vision Package.

• 401(k) Plan with Company Match.

• Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays.

• Life Insurance: Standard coverage with optional enhancements.

• Employee Assistance Program: Free counseling and coaching sessions.

• Emotional Well-being and Work-Life Balance Resources.

• Short & Long-Term Disability: Company-paid with optional supplements.

• Accidental Death and Dismemberment Insurance.

• FSA and HSA: Manage healthcare expenses.

• Commuter Spending Programs.

• Volunteer and Engagement Opportunities.

• Employee Referral Bonuses.

• Exclusive Discounts on entertainment, travel, and various other supplemental and cellphone plans.