RCM Manager- Oral Surgery

Description

We are seeking an experienced Oral Surgery Revenue Cycle Manager to lead our RCM operations at HighFive Healthcare. The ideal candidate will possess a strong background working with large healthcare providers (50 locations/providers) and a proven track record of leveraging automation and process improvements to optimize revenue capture. We are looking for a leader who can foster a collaborative team environment, drive continuous high growth, and ensure the financial health of our organization.

Responsibilities

Strategic RCM Leadership & Automation:

• Develop, implement, and oversee comprehensive revenue cycle strategies aligned with organizational goals and high-growth objectives.
• Identify, evaluate, and help implement automation technologies and solutions (e.g., RPA, AI-driven claim scrubbing, automated denial management) to enhance RCM efficiency, accuracy, and scalability.
• Champion process re-engineering efforts to streamline workflows, reduce manual intervention, and accelerate cash flow.
  
  

Process Improvement & Optimization

• Continuously analyze RCM performance metrics (e.g., A/R days, denial rates, clean claim rate, collection rates) to identify trends, root causes of issues, and opportunities for improvement.
• Lead cross-functional initiatives to optimize all stages of the revenue cycle, including insurance verification, claims submission, payment posting, denials management, and collections.
• Develop and implement best practices, policies, and procedures to ensure compliance, maximize reimbursement, and minimize revenue leakage.
  
  

Team Leadership & Collaboration

• Manage, mentor, and develop a high-performing RCM team, fostering a culture of accountability, continuous learning, and excellence.
• Promote strong collaboration between RCM, operations, integrations, finance, and other departments to ensure seamless information flow and alignment on revenue cycle goals.
• Conduct regular team meetings, performance reviews, and provide constructive feedback to support professional growth.
  
  

Performance Monitoring & Reporting

• Establish and monitor key performance indicators (KPIs) and service level agreements (SLAs) for all RCM functions.
• Prepare and present detailed RCM performance reports to senior leadership, highlighting achievements, challenges, and strategic recommendations.
• Forecast revenue trends and potential risks, proactively developing mitigation strategies.
  
  

Compliance & Audit

• Ensure strict adherence to all relevant healthcare regulations, payer requirements, HIPAA, and other compliance standards.
• Oversee and conduct audits related to billing and collections, implementing corrective actions as needed.
  
  

Vendor Management

• Manage relationships with third-party RCM vendors, billing services, and technology providers to ensure optimal performance and cost effectiveness through SLA’s and quality audits.
  
  

Requirements

Education:

• Bachelor's degree required. Preferred fields include Healthcare Administration, Business Administration, Finance, or related discipline.
  
  

Experience

• Oral Surgery management experience is required.
• Minimum of 3 years of progressive leadership experience in Revenue Cycle Management within a healthcare setting.
• Experience managing RCM for large healthcare providers with 30 locations or providers a strong plus.
• Demonstrated expertise in implementing and optimizing RCM automation tools and technologies.
• Proven track record of driving significant process improvements and achieving measurable results in RCM performance.
• Experience in a high-growth environment is highly desirable.]
• Coding certification is a strong plus but not required.
  
  

Skills

• Exceptional analytical and problem-solving skills with the ability to interpret complex financial data and trends.
• Strong understanding of healthcare billing, coding (CPT, ICD-10, HCPCS), claims submission, denial management, and collection processes.
• Proficiency with various RCM software, EHR/EMR systems and data analytics tools.
• Excellent leadership, communication (written and verbal), and interpersonal skills.
• Ability to work collaboratively across departments and influence stakeholders at all levels.
• Highly organized, detail-oriented, and able to manage multiple priorities in a fast-paced, evolving environment.