RCM Manager, Eligibility & Doctor Concierge

0507 Team TAG Services, LLC; New York (NY); Híbrido; USD 93.000 - 110.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Hybrid work arrangement

Health, dental, vision, 401(k) with 5%

Paid time off

Descripción de la vacante

The Aspen Group (TAG) is seeking a RCM Manager, Eligibility & Doctor Concierge to lead two teams focused on front-end revenue protection and best-in-class clinician support. You will oversee eligibility verification, benefits coordination, and a white-glove Doctor Concierge service, ensuring accuracy, timely responses, and compliance with payer rules.

Responsibilities include leading talent, improving workflows, auditing processes, and partnering with Revenue Cycle, IT, and field teams to drive

Formación

• Bachelor’s degree required in healthcare administration, business, finance, or related field.
• 4–6 years in eligibility/benefits verification, patient access, or revenue cycle operations.
• Experience leading teams of 2–3 supervisors or team leads.
• Familiarity with HIPAA and payer contracts.

Responsabilidades

• Lead and develop a high-performing team of eligibility specialists, concierge representatives, and auditors.
• Oversee daily eligibility/benefits verification and front-end processes to reduce denials and improve patient cost estimates.
• Own the Doctor Concierge function with a white-glove service level and escalation paths.
• Conduct audits, monitor KPIs, and drive improvements with cross-functional partners.
• Collaborate with IT, analytics, and vendor partners on EMR/configuration and reporting.

Conocimientos

Leadership

Eligibility verification

Data analysis

HIPAA knowledge

Educación

Bachelor's degree in healthcare administration or related field

Herramientas

EMR/Practice management systems

SQL/BI tools

Descripción del empleo

The Aspen Group (TAG) is one of the largest and most trusted retail healthcare business support organizations in the U.S. and has supported over 20,000 healthcare professionals and team members with close to 1,500 health and wellness offices across 48 states in four distinct categories: dental care, urgent care, medical aesthetics, and animal health. Working in partnership with independent practice owners and clinicians, the team is united by a single purpose: to prove that healthcare can be better and smarter for everyone. TAG provides a comprehensive suite of centralized business support services that power the impact of five consumer-facing businesses: Aspen Dental, ClearChoice Dental Implant Centers, WellNow Urgent Care, Chapter Aesthetic Studio, and Lovet Pet Health Care. Each brand has access to a deep community of experts, tools and resources to grow their practices, and an unwavering commitment to delivering high-quality consumer healthcare experiences at scale.

Summary

The RCM Manager, Eligibility & Doctor Concierge leads two connected teams that protect revenue at the front end of the revenue cycle and give our clinicians a best-in-class support experience: the Eligibility team, responsible for accurate and timely insurance eligibility and benefits verification support, and the Doctor Concierge team, a white glove support service that resolves insurance, coverage, and benefits questions for doctors and practice teams so they can focus on patient care. The role also owns the audit function, which independently reviews eligibility, benefits, and front-end data quality to reduce downstream denials, write-offs, and patient financial surprises. The Manager oversees day-to-day operations, sets service and quality standards, monitors performance metrics, and partners with Revenue Cycle, field operations, practice support, and technology teams to drive continuous improvement. The position requires strong operational leadership, a service-first mindset, analytical capability, and working knowledge of governmental and commercial payer rules and benefit structures.

Essential Functions, Job Duties & Responsibilities:

• Operational Leadership & Team Management Lead, coach, and develop a high-performing team of eligibility specialists, concierge representatives, and auditors, including attracting, hiring, onboarding, and retaining talent. Provide ongoing training, calibration, and performance feedback to ensure adherence to best practices, quality standards, and service expectations. Manage staffing levels, scheduling, and workload distribution across teams to meet volume, turnaround-time, and service-level goals, including peak and seasonal demand. Set clear goals and accountability through scorecards, one-on-ones, and regular team huddles. Model company values and foster a positive, collaborative, service-oriented culture.
• Eligibility & Benefits Operations Oversee daily eligibility and benefits verification support activities, including pre-visit verification, coordination of benefits, plan changes, and re-verification, to ensure accuracy and timeliness. Ensure benefit details (coverage levels, frequencies, waiting periods, limitations, deductibles, and annual maximums) are captured accurately and communicated in a way that supports treatment planning and patient cost estimates. Monitor eligibility-related denials, rejections, and registration errors; identify root causes and implement corrective actions with front-end and billing teams. Develop and refine standardized workflows, procedures, job aids, and documentation for verification and payer portal usage. Evaluate and support automation opportunities such as real-time eligibility checks (270/271), payer portal integrations, and robotic process automation to improve speed and accuracy.
• Doctor Concierge (White Glove Support) Own the design and delivery of a white glove support experience for doctors and practice teams, including intake, triage, resolution, and follow-up on insurance, benefits, and coverage questions. Establish service-level agreements, escalation paths, and communication standards that make support fast, proactive, and consistent across the organization. Serve as a trusted escalation point for complex or high-visibility cases involving coverage disputes, out-of-network situations, pre-authorization, and patient financial concerns. Gather feedback from doctors and practice leaders through surveys and regular check-ins; translate insights into service improvements. Track and report on service metrics such as response time, first-contact resolution, case volume by category, and doctor satisfaction.
• Audit & Quality Assurance Lead the audit team in conducting routine and targeted reviews of eligibility verification, benefits documentation, insurance data entry, and concierge case handling. Maintain a risk-based audit plan, sampling methodology, and quality scoring framework; calibrate auditors to ensure consistent results. Analyze audit findings to identify trends, training needs, process gaps, and payer-specific issues; deliver clear corrective action plans and track them to completion. Quantify the financial impact of eligibility errors, including avoidable denials, write-offs, and rework, and report results to leadership. Support external audits, payer audits, and internal compliance reviews by providing documentation and subject matter expertise.
• Cross-Functional Collaboration Partner with field operations, practice support, patient access, billing, collections, credentialing and enrollment, and shared services to align front-end processes with downstream revenue cycle outcomes. Collaborate with IT, analytics, and vendor partners on EMR and practice management system configuration, issue resolution, and data extraction for reporting. Participate in cross-functional projects that affect eligibility, patient financial experience, payer relations, or system enhancements. Oversee and maintain relationships with external vendors who are supporting eligibility task and estimation support. Develop work flows, work assignments, and monitoring of SLAs with associated task.
• Financial & Analytical Responsibilities Monitor key performance indicators and develop action plans to improve results, such as verification accuracy, eligibility-related denia/rejection rate, turnaround time, productivity, audit pass rate, and doctor satisfaction. Prepare and present routine performance reports and dashboards to management, with insights and recommended operational adjustments. Analyze the connection between eligibility accuracy/estimate accuracy, denials, AR aging, and bad debt to support month-end review and forecasting. Manage team budget, productivity targets, and resource planning in partnership with finance and leadership.
• Payer Relations & Compliance Monitor payer trends, plan and benefit changes, and regulatory updates; communicate impacts to teams and escalate issues with recommended solutions. Participate in internal and external meetings and support issue resolution related to eligibility, benefit accuracy, and estimation accuracy Ensure compliance with HIPAA, minimum necessary standards, and all payer-specific requirements, including secure handling of PHI in all concierge and audit activities.
• Continuous Improvement Identify opportunities to streamline processes, improve accuracy, and enhance the patient, doctor, and practice team experience. Support system upgrades, vendor evaluations, and implementation efforts, including testing and training. Contribute to best-in-class practices that support organizational growth and scalability.

Minimum Qualifications

Education Bachelor’s degree required in healthcare administration, business, finance, or a related field; equivalent combination of education and relevant experience may be considered.

Experience 4–6 years of experience in eligibility and benefits verification, patient access, medical or dental billing, insurance reimbursement, or revenue cycle operations. 2–3 years of people leadership experience managing teams, including supervisors or team leads, in a production or contact center environment. Experience in managing virtual teams, as well as off shore vendor teams. Experience in a growing, multi-site healthcare environment preferred. Experience in quality assurance, auditing, or compliance monitoring preferred. Experience supporting clinicians or providers in a customer service, concierge, or client-facing support role preferred.

Knowledge Strong working knowledge of the end-to-end revenue cycle, with emphasis on front-end processes and their impact on claims, denials, and collections. Solid understanding of commercial, Medicare, and Medicaid eligibility and benefits rules, coordination of benefits, plan types (HMO, PPO, indemnity), and network status. Familiarity with HIPAA, standard EDI transactions (270/271, 837, 835), and payer portal and clearinghouse tools. Knowledge of audit methodology, sampling, quality scoring, and root cause analysis. Understanding of service-level management and customer experience metrics.

Skills Proven ability to lead, coach, and motivate teams and to manage performance through data and clear expectations. Exceptional service orientation, with the ability to communicate clearly and diplomatically with doctors, practice leaders, and executives. Strong analytical skills, with proficiency in Microsoft Office, particularly Excel, and experience with reporting and dashboard tools; familiarity with SQL or BI tools a plus. Proficiency with EMR/practice management systems, ticketing or case management tools, and RCM technologies. Ability to read and interpret payer contracts, fee schedules, and benefit summaries. Demonstrated ability to manage multiple priorities and projects, drive process improvement, and collaborate across departments. Strong written and verbal communication, organizational, problem-solving, and decision-making skills.

Preferred Certifications Certified Revenue Cycle Specialist (CRCS), Certified Revenue Cycle Representative (CRCR), Certified Professional Biller (CPB), Certified Healthcare Access Associate (CHAA), or similar credential. Lean Six Sigma, process improvement, or customer service leadership certification. Dental or specialty billing experience or credentials, where applicable to the practice setting.

Base Salary Range: $93,000-110,000, annually with a 10% bonus.

This position offers a hybrid or remote work arrangement based on your location. Candidates residing within 35 miles of our Chicago, IL (Fulton Market) office or within 45 miles of our East Syracuse, NY office are expected to work on-site. Candidates living outside of these areas are eligible for full remote work.

A generous benefits package that includes paid time off, health, dental, vision, and 401(k) savings plan with match.

If you are an applicant residing in California, please view our privacy policy here: https://careers.aspendental.com/us/en/tag-privacy-policy-for-california-employees