What are the responsibilities and job description for the Revenue Cycle Management (RCM) Manager - Dermatology Practice position at Blue Ocean Dermatology?
We are seeking a highly motivated and experienced Revenue Cycle Management (RCM) Manager to oversee all aspects of the credentialing, billing and collections process for our growing dermatology practice. The successful candidate will be pivotal in optimizing revenue, minimizing claim denials, and ensuring strict compliance with all healthcare billing regulations (HIPAA, MIPS, CMS, etc.).
Key Responsibilities
- Oversee the Entire Billing Cycle: Manage and monitor all steps from insurance credentialing, patient registration and insurance verification, obtaining authorizations, to charge entry, claim submission, payment posting, and collections.
- Denial Management & Appeals: Investigate and resolve claim denials and rejections efficiently, implementing processes to prevent future issues and manage the appeals process.
- Accounts Receivable (AR) Management: Monitor and manage accounts receivable activity to ensure timely reimbursement and optimize cash flow.
- Compliance & Regulation: Ensure all billing processes comply with healthcare regulations, coding standards (CPT, ICD-10, HCPCS), and payer-specific guidelines. Stay updated on changes in billing regulations and implement necessary changes.
- Team Leadership & Development: Lead, train, and manage a team of billing specialists, providing guidance, monitoring workflow, and conducting performance evaluations.
- Reporting & Analytics: Generate detailed financial reports and analyze Key Performance Indicators (KPIs), such as denial rates and collection rates, to identify trends and areas for process improvement.
- Collaboration: Facilitate effective communication and collaboration between the RCM team, clinical staff, and front desk services to resolve billing-related issues and ensure a seamless patient experience.
- Credentialing: Oversee provider credentialing with Medicare and all commercial insurance carriers.
Required Skills & Abilities
- In-depth knowledge of healthcare revenue cycle operations and reimbursement methodologies.
- Strong understanding of medical billing software and Electronic Health Record (EHR) systems (experience with EMA/Modernizing Medicine a plus).
- Proficiency in medical coding (ICD-10, CPT, HCPCS).
- Proven leadership and team management skills.
- Excellent analytical, problem-solving, and critical thinking abilities.
- Strong written and verbal communication skills for interacting with staff, insurance providers, and patients.
- High level of attention to detail and ability to maintain accurate records.
Qualifications & Experience
- Bachelor's degree in Business Administration, Finance, Healthcare Administration, or a related field (preferred).
- 5 years of progressive experience in healthcare revenue cycle management, with 2 years in a leadership role.
- Prior experience specifically within a dermatology or multi-specialty practice is a strong plus.
Benefits
Competitive salary, Health/Dental/Vision insurance, 401k Plan, Paid Time Off
Job Type: Full-time
Pay: From $62,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Ability to Commute:
- Port Orange, FL 32127 (Required)
Work Location: In person
Salary : $62,000