Sr Mgr RCM

The Senior Manager of Revenue Cycle Management will play a pivotal role in ensuring the financial health of our organization by overseeing one of the four primary functional areas within the Revenue Cycle Management department. This role requires a highly analytical and strategic thinker who can lead the development and execution of revenue cycle strategies for their designated functional area which consists of at least three RCM service addition the Senior Manager will manage a team of in-house ATI employees and oversee the performance of a large offshore vendor team comprising over 100 team members.

Develop and execute the strategic direction for the designated functional area aligning it with the overall goals of the organization and the Revenue Cycle Management department.
Lead mentor and motivate a team of ATI employees to ensure optimal performance productivity and professional growth
Establish monitor and act on operational KPIs to enhance the efficiency and effectiveness of revenue cycle operations utilizing data-driven insights with a deep understanding of their direct impact on ATIs Revenue Recognition model.
Own the vendor relationship for their functional area ensuring that they meet SLA performance metrics adhere to policies/procedures productivity & quality of day-to-day operations
Ensure all revenue cycle activities adhere to legal and regulatory compliance requirements (e.g. SOX compliance Government & Commercial Payor guidelines and internal ATI policies).
Collaborate with other departments such as Clinical Operations IT HR and Finance to streamline processes and improve revenue cycle outcomes.
Generate regular reports for senior leadership highlighting the performance and progress of the designated functional area.
Coordinates with the Rev Cycle Optimization team on technology or process optimization projects

Measurable Scope and Accountability
Depending on the Functional area the following applies:
1. Financial Clearance: If leading the Financial Clearance functional area ensure timely verification of patient insurance coverage eligibility and authorizations. This functional area is also responsible for the Queue Management Team which maintains claim based workqueues and processes all the faxes sent to clinics.
2. Central Business Office: If overseeing the Central Business Office oversee billing & rejection wqs Documentation team and Payment Posting including credit processing.
3. Govt/Comm/SP AR Follow Up: Manage the resolution of government commercial and self pay accounts receivable issues including denial appeals unworked claims and adjustment process. Responsible for the billing customer service team and resolving disputes timely with an emphasis on patient satisfaction.
4. WC/API AR Follow Up: If managing the WC/API AR Follow Up area ensure efficient management of workers compensation personal injury and auto accident-related accounts receivable. This includes both litigated and non-litigated AR.

Minimum Education
Required:
High School Diploma GED or suitable equivalent
Some Post High School Education or suitable equivalent
Preferred:
Bachelors degree in Healthcare Administration Business Finance or related field

Minimum Experience
Required:
Minimum of 7 years of experience in revenue cycle management with at least 2 years in a managerial or leadership role
In-depth knowledge of healthcare revenue cycle processes including financial clearance billing collections and accounts receivable.
Proven experience managing both in-house and offshore team members.
Preferred:
Physical Therapy or other professional billing experience
RCM Technology vendor experience

Knowledge Skills and Abilities
Strong analytical and problem-solving skills with the ability to use data to drive decision-making.
Excellent communication and interpersonal skills.
Understanding of healthcare compliance regulations including HIPAA.
Proficiency with revenue cycle management software.
Excellent in Microsoft Office applications capable of creating detailed analyses using pivot tables and other formulas/features within Excel.

Licenses and Certifications
Required:

Preferred:
Relevant industry certifications (e.g. HFMA AAPC)