Medical Billing Operations Manager jobs

RCM Operations Manager / Revenue Cycle Operations Manager

Location: Remote

Job Type: Full-time

Work Schedule: Must be available during U.S. business hours with strong overlap with EST time zone. Occasional meetings may require flexibility based on client and internal team needs.

About the Role

We are looking for a highly organized, experienced, and accountable RCM Operations Manager to oversee day-to-day revenue cycle operations across multiple healthcare clients.

This is not a basic billing role. This position requires someone who can manage teams, monitor productivity, control backlogs, reduce denials, resolve escalations, enforce SOPs, and keep operations running smoothly without constant supervision.

The ideal candidate must have strong hands-on experience in medical billing, payment posting, claim rejections, denials, AR follow-up, credentialing coordination, productivity management, and client reporting.

The main goal of this role is to make sure the operation runs smoothly, work is completed on time, team members are held accountable, and client issues are identified and resolved before they become major problems.

Key Responsibilities

1. Daily Operations Management

• Oversee daily operations for billing, payment posting, rejection management, denial management, AR follow-up, credentialing follow-up, and patient billing support.
• Monitor daily work queues by client, payer, team member, and process.
• Ensure all claims, rejections, denials, payments, and AR follow-ups are completed within defined turnaround times.
• Identify operational bottlenecks and take corrective action quickly.
• Make sure no process depends on the business owner for routine follow-up or escalation.

2. Team Management & Accountability

• Manage billing/posting team lead, denial team lead, claim status checker, EDI rejection specialist, credentialing specialist, coding support, and other RCM staff as assigned.
• Assign daily priorities and ensure team leads distribute work properly.
• Review daily productivity reports and identify low performance, training gaps, or lack of ownership.
• Hold team members accountable for productivity, quality, attendance, and timely completion of assigned work.
• Escalate repeated performance issues to HR and leadership with proper documentation.

3. KPI, SLA & Dashboard Management

• Create and maintain daily and weekly operational dashboards.
• Track key metrics including:
• Charge lag
• Claim submission volume
• Rejection volume and aging
• Denial volume and aging
• AR aging
• Payment posting lag
• Unposted payments
• Unapplied payments
• Appeals submitted
• Claims pending client/provider response
• Credentialing pending items
• Ensure all departments meet defined SLAs and productivity targets.
• Prepare weekly leadership reports and monthly client performance summaries.

4. Rejection, Denial & AR Control

• Monitor rejection and denial trends by payer, provider, CPT, modifier, location, and root cause.
• Ensure rejections are reviewed and corrected daily.
• Ensure denials are worked with proper documentation, appeal action, payer follow-up, and next follow-up date.
• Review top denial reasons and implement corrective action plans.
• Work with billing, coding, credentialing, and client teams to prevent recurring issues.

5. Payment Posting & Reimbursement Oversight

• Ensure ERAs, EOBs, and manual payments are posted accurately and timely.
• Monitor unposted payments, unapplied cash, credit balances, and payment discrepancies.
• Identify underpayments, incorrect adjustments, payer processing issues, and posting errors.
• Ensure payment posting is reconciled properly with deposits and remittance records.

6. Credentialing & Enrollment Coordination

• Monitor credentialing and payer enrollment status for providers and groups.
• Maintain visibility into payer effective dates, pending applications, revalidations, CAQH updates, EFT/ERA enrollment, and payer follow-ups.
• Ensure billing teams are aware of provider participation status before claims are submitted.
• Prevent credentialing-related denials through proper tracking and communication.

7. SOP, Process Improvement & Quality Control

• Create, update, and enforce SOPs for billing, posting, rejections, denials, AR, credentialing, and client communication.
• Perform QA reviews on team work to identify errors and training needs.
• Build repeatable workflows so the company can scale to more clients without operational breakdown.
• Recommend automation, reporting improvements, and workflow changes where needed.

8. Client & Escalation Management

• Act as the first level of operational escalation before issues reach the business owner.
• Track all client/provider issues with owner, due date, status, and next action.
• Prepare clear updates for leadership and clients.
• Ensure client requests are acknowledged, assigned, followed up, and closed timely.
• Escalate only high-risk issues involving revenue loss, client dissatisfaction, compliance concerns, or staffing problems.

Required Experience

• Minimum 8+ years of U.S. healthcare revenue cycle management experience.
• Minimum 3+ years of team lead, supervisor, or operations management experience in RCM.
• Strong knowledge of:
• Medical billing
• Charge entry
• Claim submission
• Clearinghouse rejections
• Denial management
• AR follow-up
• Payment posting
• ERA/EOB posting
• Patient billing
• Credentialing coordination
• Payer portals
• Experience managing remote teams.
• Strong understanding of commercial insurance, Medicare, Medicaid, and payer-specific billing rules.
• Ability to manage multiple clients, multiple specialties, and multiple billing systems.

Preferred Experience

• Experience with multispecialty billing.
• Experience with systems such as Tebra/Kareo, DrChrono, eClinicalWorks, Office Ally, Availity, Inovalon, Change Healthcare, TriZetto, Navinet, and payer portals.
• Experience creating dashboards, productivity trackers, SOPs, and client performance reports.
• Experience working with NY/NJ payers is strongly preferred.

Required Skills

• Strong leadership and accountability mindset.
• Excellent written and verbal communication.
• Strong Excel/Google Sheets skills.
• Ability to analyze reports and identify operational problems.
• Ability to manage deadlines, backlogs, and team productivity.
• Strong attention to detail.
• Ability to work independently without micromanagement.
• Comfortable making decisions and escalating only when necessary.
• Process-driven and numbers-driven.

What Success Looks Like in This Role

The right candidate will be expected to:

• Reduce daily dependency on the business owners.
• Ensure all teams follow daily workflows and SLAs.
• Keep rejections, denials, AR, and posting queues under control.
• Improve team productivity and accountability.
• Identify root causes instead of repeatedly fixing the same issues.
• Create clear reporting so leadership always knows what is happening.
• Keep client issues organized and prevent last-minute escalations.
• Help build a scalable RCM operation that can handle more clients.

Key Performance Indicators

Performance will be measured using:

• Claim submission turnaround time
• Rejection resolution turnaround time
• Denial work volume and resolution quality
• AR follow-up productivity
• Payment posting turnaround time
• Unposted payment backlog
• Denial aging
• AR aging movement
• Team productivity
• QA error rate
• Client issue closure rate
• SLA compliance by department

Candidate Must Not Be

This role is not suitable for someone who:

• Only has individual billing experience and no team management experience.
• Waits for instructions instead of taking ownership.
• Cannot read reports or identify operational problems.
• Avoids difficult conversations with team members.
• Gives vague updates without numbers.
• Escalates every small issue to leadership.
• Has no experience managing remote staff.
• Cannot work under deadlines.

Application Requirements

To apply, please send:

• Updated resume
• Summary of your RCM management experience
• List of billing systems and clearinghouses you have used
• Number of team members you have managed previously
• Example of how you improved an RCM process, reduced backlog, improved collections, or controlled denials
• Your expected monthly compensation
• Your availability during U.S. business hours

Interview Process

Shortlisted candidates may be asked to complete a practical assessment involving:

• Reviewing sample RCM dashboards
• Identifying operational issues
• Prioritizing backlogs
• Creating an action plan for billing, rejections, denials, AR, and payment posting
• Explaining how they would manage team productivity and escalations

We are looking for someone who can take ownership, bring structure, and help run the operation with discipline and accountability.

Application Question(s):

• How many years of U.S. healthcare RCM experience do you have?
• Have you directly managed or supervised an RCM team before?
• How many team members have you directly managed at one time?
• Have you managed remote team members before?
• Which RCM areas have you personally managed?
• Have you created or managed daily/weekly RCM productivity reports or dashboards?
• Are you comfortable holding team members accountable for low productivity, poor quality, missed deadlines, and repeated errors?
• What is your expected monthly compensation? Please provide a clear expectation
• When can you start if selected?

Work Location: Remote

Pay: ₹50,000.00 - ₹100,000.00 per month

Application Question(s):

• How many years of U.S. healthcare RCM experience do you have?
• Have you directly managed or supervised an RCM team before?
• How many team members have you directly managed at one time?
• Have you managed remote team members before?
• Which RCM areas have you personally managed?
• Have you created or managed daily/weekly RCM productivity reports or dashboards?
• Are you comfortable holding team members accountable for low productivity, poor quality, missed deadlines, and repeated errors?
• What is your expected monthly compensation? Please provide a clear expectation
• When can you start if selected?

Work Location: Remote