RCM Manager (Remote)

Learn Behavioral is a national organization made up of dedicated and caring individuals with the sole purpose of nurturing children with autism and special needs to lead resilient and fulfilling lives.  We specialize in contemporary, evidence based applied behavior analysis to deliver personalized treatment plans, backed by 20 years of clinical insights.  We are proud to be a part of each family’s journey and share in the experience of finding success for every child, and family, in our care.  If you share a similar passion for nurturing and empowering the success of others, along with the opportunity to have an impact on the lives of others, we are eager to connect with you!  

We are seeking a highly motivated and detail-oriented Revenue Cycle Management (RCM) Manager to oversee and manage the entire revenue cycle process within the assigned region. The RCM Manager will direct and oversee that the team is ensuring the efficient, accurate, and timely processing of patient accounts from scheduling and registration through to final payment, maximizing revenue, and ensuring compliance with all healthcare regulations and payer requirements.

• Overseeing and improving the efficiency of the RCM team to streamline processes related to billing, record-keeping, and revenue cycle management. This includes minimizing billing errors, reducing claim denials, speeding up payment collections, and ensuring accurate financial reporting.
• Establishing and maintaining relationships with insurance companies and healthcare payors, ensuring smooth communication regarding contracts, claims, reimbursement rates, policy updates, and special projects.
• Proactively identifying and addressing challenges in daily operations, taking ownership of issues, researching solutions, and implementing strategies to resolve problems efficiently while ensuring minimal workflow disruption.
• Implementing best practices and new technology to improve operational efficiency and maximize revenue potential.
• Ensuring accurate claim submission and A/R follow-up, including accounts management, daily balancing controls, reporting, and completion of month-end and audit activities.
• Providing A/R reporting and overseeing payment allocation across the regions for month-end and audit purposes.
• Ensuring RCM departmental metrics and goals are met regarding KPIs like write-offs, DSO/DRO, cash collections, and bucket percentage.
• Managing denials and appeals and conducting A/R follow-up to ensure timely reimbursement.
• Reviewing accounts and making recommendations regarding non-collectible accounts.
• Maintaining confidentiality and adhering to HIPAA regulations at all times.
• Staying up to date on payers’ reimbursement guidelines through educational activities.
• Maintaining team documentation such as procedural manuals and cross-training resources.
• Demonstrating professionalism, teamwork, and critical thinking while delivering exceptional customer service.
• Conducting training and weekly A/R calls to ensure continuous improvement and team alignment.
• Leading monthly KPI calls to update clinical and operational stakeholders on the team's progress toward achieving key performance indicators (KPIs).

• BA in Business or Health Administration required
• 5+ years of RCM experience as well as A/R Management
• Remittance Advice, Customer Service, Policy implementation
• Advanced knowledge of Microsoft Excel
• Proficiency in Microsoft Office Suite (Word, PowerPoint, Outlook)
• 5+ years of experience in RCM billing and collections
• Strong organizational and customer service skills
• Detail-oriented with a high level of accuracy
• Comprehensive knowledge of HCPCS, ICD-10, CPT coding, and professional claim forms
• Experience with EDI reports
• Excellent verbal and written communication skills
• Extensive experience managing high-level appeals and follow-up processes
• Credentialing and certification knowledge
• Ability to meet deadlines and work well under pressure
• Effective communication with RCM team members, clinicians, operational stakeholders, and payers
• Strong interpersonal skills and a positive attitude
• Exceptional problem-solving and critical thinking abilities
• Ability to work both independently and collaboratively in a team environment
• This role has supervisory responsibilities and serves as a coach and mentor for other employees, at times.

LEARN Behavioral offers competitive compensation, a comprehensive benefits plan, including 401(k), personal time off, paid holidays, and tuition reimbursement.

LEARN Behavioral is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Candidates must be presently eligible to work in the United States.