RCM Manager: AR & Denials Optimization Lead

Sunshine Pediatric And Family Clinic Private; United States; A distancia; USD 90.000 - 130.000; Jornada completa

Descripción de la vacante

Sunshine Pediatric & Family Clinic is seeking an experienced RCM Manager to lead US healthcare revenue cycle operations, optimize reimbursement, and reduce outstanding AR. The role requires strong denials management, team leadership, and cross‑functional collaboration to improve workflows and revenue integrity.

You will oversee billing, follow-up, appeals, and payer communications, driving process improvements, audits, and coaching to enhance performance across the RCM team.

Formación

• Strong experience in U.S. Healthcare RCM / Medical Billing.
• Previous experience managing an RCM or AR team.
• Strong knowledge of AR follow-up, denials, claim processing, EOB/ERA analysis, appeals, and payer workflows.
• Ability to independently analyze complex billing and reimbursement issues.
• Strong Excel/Google Sheets and reporting skills.
• Excellent leadership, communication, and problem-solving skills.
• Experience with eClinicalWorks (eCW) is preferred

Responsabilidades

• Manage day-to-day RCM, billing, AR, and denial management operations.
• Monitor AR aging, with special focus on 60+, 90+, and 120+ outstanding claims.
• Identify unpaid, underpaid, rejected, and denied claims and ensure timely resolution.
• Analyze recurring denials and implement root-cause corrective actions.
• Monitor payer-specific issues and escalate unresolved reimbursement problems.
• Ensure accurate and timely claim submission, follow-up, appeals, and corrected claims.
• Track expected vs. actual payments and identify potential underpayments and revenue leakage.
• Manage and monitor RCM team productivity, quality, and accountability.
• Conduct regular audits and provide training/coaching where performance gaps are identified.
• Develop and improve RCM workflows, SOPs, trackers, and automation.
• Coordinate with clinical, front-office, credentialing, and other teams when their workflows impact reimbursement.
• Provide management with clear reporting on AR, collections, denials, outstanding issues, and action plans.

Conocimientos

RCM/Medical Billing

AR follow-up

Denials management

Leadership

Excel/Google Sheets

Reporting & analytics

Communication

Process improvement

Herramientas

eClinicalWorks (eCW)

Descripción del empleo

Sunshine Pediatric & Family Clinic is seeking an experienced RCM Manager to lead US healthcare revenue cycle operations, optimize reimbursement, and reduce outstanding AR. The role requires strong denials management, team leadership, and cross‑functional collaboration to improve workflows and revenue integrity.

You will oversee billing, follow-up, appeals, and payer communications, driving process improvements, audits, and coaching to enhance performance across the RCM team.