RCM AR Follow-Up Manager

Hyderabad - India

Monthly Salary: Not Disclosed

Posted on: 30+ days ago

Vacancies: 1 Vacancy

Job Summary

ClinicMinds core valuesExcellence Learning Teamwork guide everything we build.
With150 inhouse analysts half a dozen BPO partners and a proprietary billing platform we now need a manager to deliver bestinclass collections continue to improve performance automate and meet the RCM needs of a rapidly growing client base.

Position Summary:

The RCM AR Follow-Up Manager oversees the daily operations of the Accounts Receivable team responsible for timely follow-up and resolution of billed medical insurance claims. This role ensures that outstanding claims are pursued denials are addressed promptly and payments are collected efficiently to maintain optimal cash flow and reduce aged receivables. The manager serves as the liaison between the AR staff billing team payers and leadership to ensure compliance productivity and accuracy in all AR activities.

Key Responsibilities:

1. Leadership and Oversight

Supervise train and mentor a team of AR follow-up specialists and lead representatives.
Assign workloads monitor productivity and track key performance indicators (KPIs) such as Aging and claim resolution rate.
Conduct regular team meetings to discuss performance process improvements and payer updates.
Foster a positive accountable and results-driven team culture.

2. AR Management

Oversee the timely and accurate follow-up on all unpaid underpaid and denied insurance claims across all payer types.
Ensure all claims are followed up in accordance with payer timely filing limits.
Monitor and analyze aging reports to identify trends payer issues and root causes of delays.
Work closely with the billing and cash posting teams to reconcile discrepancies and resolve claim-related issues.

3. Process and Performance Optimization

Develop and implement policies procedures and workflows to streamline AR operations.
Evaluate and improve claim follow-up strategies to enhance collections and minimize rework.
Utilize reports and dashboards to track team performance and identify improvement opportunities.
Collaborate with IT or system administrators to optimize billing software tools and automation.

4. Payer and Denial Management

Maintain strong relationships with insurance representatives to expedite claim resolution.
Oversee the research and resolution of complex claim denials and payment variances.
Provide feedback to billing and coding teams on denial trends and documentation needs.
Ensure appeals are filed accurately and timely with proper documentation and justification.

5. Compliance and Quality Assurance

Ensure all AR activities comply with HIPAA payer contracts and company policies.
Maintain confidentiality of patient information and financial data.
Conduct periodic quality audits to ensure accuracy in claim follow-up and note documentation.
Stay current with payer regulations policy changes and industry best practices.

6. Reporting and Communication

Prepare and present weekly monthly and quarterly AR performance reports to senior management.
Communicate collection trends issues and successes across the revenue cycle leadership team.
Recommend actionable strategies to reduce days in AR and improve cash flow.

Qualifications:

Education:

Associates or bachelors degree in business administration Healthcare Management or related field preferred.
Equivalent combination of education and experience may be considered.

Experience:

5 years of progressive experience in medical billing AR follow-up or revenue cycle management.
2 years in a supervisory or management role overseeing AR or collections teams.
Strong knowledge of payer policies denial management and reimbursement methodologies (commercial Medicare Medicaid PIP workers comp etc.).

Skills & Competencies:

Proficiency in billing systems and electronic health record (EHR) software.
Advanced Excel and data analysis skills.
Strong leadership coaching and team-building abilities.
Excellent problem-solving analytical and organizational skills.
Clear communication and negotiation skills with internal staff and payer representatives.
Ability to manage multiple priorities in a fast-paced environment.
High attention to detail

Performance Metrics:

Days in AR (goal: maintain below industry benchmark)
AR >90 days percentage
Denial rate and resolution rate
Cash collections to net revenue ratio
Team productivity (claims followed up per day)
Timeliness and accuracy of claim follow-up documentation

Must Have:

High comfort level working on Eastern Time Zone/US Shift
Good internet access at home
Mobile Hotspot
Laptop/Desktop with at least 16 GB

Required Experience:

Manager

ClinicMinds core valuesExcellence Learning Teamwork guide everything we build.With150 inhouse analysts half a dozen BPO partners and a proprietary billing platform we now need a manager to deliver bestinclass collections continue to improve performance automate and meet the RCM needs of a rapidly ...