RCM Operations Manager

CF Solutions Philippines Inc.; Quezon City; On-site; PHP 1,000,000 - 1,600,000; Full time

Job summary

CF Solutions Philippines Inc. is seeking an experienced RCM Operations Manager to lead end-to-end Revenue Cycle Management operations in the Philippines.

You will drive operational excellence, oversee daily RCM functions, and manage high-performing teams to maximize revenue while ensuring regulatory compliance. You will monitor KPIs such as clean claim rate, denial rate, days in A/R, and authorization turnaround times, identifying bottlenecks and implementing improvements.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or related field.
• Minimum of 5 years of leadership experience in Revenue Cycle Management.
• Strong knowledge of insurance verification, prior authorization, medical billing, claims processing, accounts receivable management, denial management, and payment posting.

Responsibilities

• Manage daily operations of the Revenue Cycle Management department
• Lead and develop RCM supervisors, team leads, and staff to achieve operational goals
• Monitor and improve KPIs including clean claim rate, first-pass resolution rate, days in A/R, denial rate, collection rate, and authorization turnaround times
• Identify operational bottlenecks and implement process improvements
• Develop strategies to maximize reimbursement and reduce claim denials
• Collaborate with clients, providers, payers, and cross-functional teams to resolve escalated revenue cycle issues
• Ensure compliance with HIPAA, payer regulations, and company policies
• Analyze operational reports and present insights and recommendations to senior leadership
• Support workforce planning, forecasting, and resource allocation
• Lead training, coaching, and performance management initiatives

Skills

Leadership

Analytical skills

Communication

Stakeholder management

Excel analytics

EMR/EHR

Healthcare regulations

RCM certs

Education

Bachelor’s degree in Healthcare Administration

Tools

Practice management systems

EMR/EHR platforms

Reporting tools

Job description

About the role

We are seeking an experienced and results-driven RCM Operations Manager to lead and optimize our Revenue Cycle Management operations. The ideal candidate will oversee end-to-end RCM functions, drive operational excellence, ensure key performance metrics are met, and lead high-performing teams responsible for maximizing revenue collection and maintaining compliance with healthcare regulations.

Key responsibilities

• Manage daily operations of the Revenue Cycle Management department

• Lead and develop RCM supervisors, team leads, and staff to achieve operational goals

• Monitor and improve key performance indicators (KPIs), including clean claim rate, first-pass resolution rate, days in A/R, denial rate, collection rate, and authorization turnaround times

• Identify operational bottlenecks and implement process improvements

• Develop strategies to maximize reimbursement and reduce claim denials

• Collaborate with clients, providers, payers, and cross-functional teams to resolve escalated revenue cycle issues

• Ensure compliance with HIPAA, payer regulations, and company policies

• Analyze operational reports and present insights and recommendations to senior leadership

• Support workforce planning, forecasting, and resource allocation

• Lead training, coaching, and performance management initiatives

About you

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field

• Minimum of 5 years of leadership experience in Revenue Cycle Management

• Strong knowledge of insurance verification, prior authorization, medical billing, claims processing, accounts receivable management, denial management, and payment posting

• Experience managing large operational teams in a healthcare or RCM environment

• Strong analytical and reporting skills

• Excellent communication and stakeholder management abilities

• Proficiency in healthcare practice management systems, EMR/EHR platforms, and reporting tools

• Advanced Microsoft Excel and data analysis skills

• Preferred: CPC, CPB, CRCR, or other relevant healthcare certifications