Manager of Revenue Cycle Management - Remote (US)
Remote · United States or Novi, Michigan, United States
Job Summary
Theoria Medical seeks a Senior Manager of Revenue Cycle Management to lead and optimize the revenue cycle for its physician group. The role oversees billing, holds/credentialing, denials, collections, and accounts receivable management, develops and implements KPIs and policies to ensure timely claim submission, reduces denials, and increases collections, analyzes trends in charges, coding, and payer behavior, and coordinates with offshore RCM teams and third-party vendors. The ideal candidate will drive payer negotiations, manage underpayments/overpayments, ensure regulatory compliance (HIPAA and related regulations), and collaborate with Credentialing, HR, Clinical Operations, and other departments to maintain a smooth revenue cycle operation. Strong leadership, healthcare financial acumen, CPT/ICD-10 expertise, and robust communication skills are essential.
Required Qualifications
- 7+ years of experience in revenue cycle management in a healthcare setting
- Advanced knowledge of the healthcare industry and a strong financial background
- Clear understanding of billing and collection regulatory guidelines and requirements
- Vast CPT and ICD-10 expertise
- Vast knowledge in credentialing and payor management
- Proficient background in reimbursements
- Experience in monitoring clearinghouse activity, reports, and processes
- Experience in setting up payors with EDI, ERA, and EFT processes
- Experience in managing and leading a team of revenue cycle professionals
- Strong analytical skills and attention to detail
- Excellent communication and interpersonal skills
- Ability to work in a fast-paced environment and manage multiple projects simultaneously
- Agility, strong leadership, problem-solving skills
- Ability to maintain up-to-date knowledge of technology and software including but not limited to Monday, Slack, Google suite of Applications, spreadsheets (Excel), Zoom, MS Teams, eClinicalWorks
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