Revenue Cycle Management (RCM) Manager

$65,000 - $125,000/Yr

Vitalus Health - Houston, TX

Full-time - Mid Level

Houston, TX

Health and Personal Care Retailers

About the position

The Revenue Cycle Management (RCM) Manager at Vitalus Health is responsible for overseeing all billing operations, ensuring compliance with healthcare regulations, and developing strategies to improve financial performance. This role involves analyzing billing processes, managing receivables, and presenting findings to senior leadership to enhance collections and profitability. The RCM Manager will lead a team, implement policies, and drive initiatives to optimize the revenue cycle and maximize reimbursement.

Responsibilities

• Oversee all billing operations including billing, payor performance, and financial reconciliation.
• Analyze and develop strategies to improve billing processes and minimize bad debt.
• Ensure compliance with Medicare and healthcare regulations.
• Present analyses and recommendations to the CFO, CEO, and Advisory Board.
• Develop strategic plans for the Revenue Cycle team and set clear goals and objectives.
• Direct and oversee RCM functions to drive efficient and compliant billing activities.
• Review billing activities and manage the authorization, billing, and collections staff.
• Implement policies and procedures for consistent company-wide practices.
• Monitor and communicate changes in insurance carrier rules and regulations.
• Compile and prepare status reports for management to analyze trends.

Requirements

• Bachelor's Degree in Business, Healthcare Administration, or equivalent.
• 5+ years of experience in Revenue Cycle Management, with at least 3 years as an RCM Manager.
• 5+ years of experience in Sleep (and/or Neuro) Diagnostic/DME billing with EDI management.
• Experience with Brightree preferred (3+ years).
• Certified Coder (CPC, CCS, or CMC).
• Knowledge of carrier billing rules, modifiers, and CPT/HCPCS rules.
• Understanding of HIPAA regulations and their impact on operations.

Nice-to-haves

• Demonstrated coding and billing knowledge/experience preferred.
• Experience with EDI management through a clearinghouse.
• Knowledge of professional fee billing and third-party payer regulations.

Benefits

• Competitive salary ranging from $65,000 to $125,000 per year.
• Opportunities for professional development and training.