The RCM Manager is responsible for managing designated clinic medical claims processing, payment posting and follow up. This position works with the computerized practice management system for the validation, submission, and processing of insurance and self-pay claims. The position is responsible for collecting and entering claim information, validation, and correction of rejected claims, and claim submission to payers for reimbursement.

The RCM Manager also assigns and monitors workload and process workflow for an assigned group of employees. This position also provides continual education and on the job training to staff as areas of opportunity are identified. The RCM Manager will work closely with the RCM Director to set monthly goals, key performance indicators, monitor performance, and provide feedback up and down the department chain. This position is a key change agent in identifying opportunities for improvement within the claims processing workflow for revenue cycle.

Responsibilities:

Enter information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information
Ensure claim information is complete and accurate
Review insurance claims submitted to clearinghouse or individual insurance companies electronically or via paper CMS- form or UB
Follow up with insurance companies on unpaid or rejected claims
Resolve claim issues
Prepare appeal letters to insurance carriers when not in agreement with claim denial
Collect necessary information to accompany appeal
Provide necessary information to collection agencies for delinquent or past due accounts
Compile data for trending of errors and rejected claims
Serve as a resource for claims analysts and account representatives
Direct daily operational tasks to ensure completion and adherence to policy and procedure to achieve set KPI goals
Review at random claims per employee for audit purposes each week and provide feedback on findings
Produce productivity reports and share with the team weekly
Create reports of compiled data to present to leadership for issue escalation and resolution
Adapt to constantly changing work environment with emphasis on attention to detail
Work collaboratively within the department and organization
Maintain confidentiality
Work independently and remote as needed
Exhibit excellent organizational skills and ability to prioritize and coordinate workload with proficiency and accuracy
Perform other duties as assigned or requested; job specifications may be modified or updated at any time

Qualifications:

High School Diploma or GED required; Bachelor's degree preferred
Minimum of three years experience in healthcare, insurance, or revenue cycle operations required
Medical billing and coding certification preferred
Experience with Microsoft Excel, RCM Management, KPI Monitoring, Payment Posting, Follow up, and Medical Billing preferred (5 years each)

Location: In person in Birmingham, AL 35205

Pay: From $25.00 per hour

Benefits:

401(k) and 401(k) matching
Dental, health, and vision insurance
Flexible schedule and flexible spending account
Paid time off
Retirement plan