RCM Supervisor

Job Description

Job Description

Job Title: Revenue Cycle Management (RCM) Supervisor
Department: Revenue Cycle Management
Reports To: Manager of Revenue Cycle Services

Position Summary

The RCM Supervisor is responsible for overseeing daily revenue cycle operations for a portfolio of independent physician practices served by the company. This role supervises billing, collections, payment posting, denial management, and accounts receivable teams to ensure clients achieve optimal reimbursement, reduced A/R days, and high clean-claim rates. The RCM Supervisor serves as a key liaison between clients, payers, providers, and internal teams, ensuring service excellence and compliance with industry regulations.

Essential Duties and Responsibilities

Team Leadership

• Supervise and support a team of billing specialists, A/R representatives, payment posters, and denial management staff.
• Monitor productivity, quality, and performance against established KPIs.
• Conduct employee coaching, training, and performance evaluations.
• Assist with recruiting, onboarding, and staff development initiatives.
• Foster a culture of accountability, customer service, and continuous improvement.

Revenue Cycle Operations

• Oversee end-to-end revenue cycle processes for assigned physician practice clients.
• Ensure timely claim submission and resolution of claim edits and rejections.
• Monitor insurance follow-up activities and collection efforts.
• Review and manage aged accounts receivable and work queues.
• Ensure accurate payment posting, adjustments, and reconciliation activities.
• Oversee denial management and appeals processes to maximize reimbursement.
• Escalate payer issues and identify reimbursement trends affecting client revenue.

Client Relationship Management

• Serve as the primary operational contact for assigned client accounts.
• Participates in regular client meetings to review financial performance and operational metrics.
• Present reports on collections, A/R aging, denial trends, and revenue opportunities.
• Address client concerns and develop action plans to improve performance.
• Collaborate with providers and practice managers to resolve workflow and documentation issues impacting reimbursement.

Performance Management & Reporting

• Monitor and analyze key performance indicators, including:
  • Days in Accounts Receivable (A/R)
  • Net Collection Rate
  • Gross Collection Rate
  • First-Pass Resolution Rate
  • Clean Claim Rate
  • Denial Rate
  • Aging Over 90 and 120 Days
  • Charge Lag
  • Payment Posting Turnaround Time
• Prepare and distribute operational and financial reports to management and clients.
• Identify revenue leakage and recommend corrective actions.

Compliance & Quality Assurance

• Ensure compliance with HIPAA, payer regulations, and billing guidelines.
• Monitor adherence to Medicare, Medicaid, and commercial payer requirements.
• Conduct quality audits of claims, payment posting, and collection activities.
• Maintain documentation and process standards required for client contracts and audits.

Process Improvement

• Identify workflow inefficiencies and implement best practices.
• Collaborate with coding, credentialing, and implementation teams to improve revenue cycle outcomes.
• Support system enhancements, software implementations, and automation initiatives.
• Develop standard operating procedures (SOPs) and training materials.

Qualifications

Education

• Associate's degree required; Bachelor's degree in Healthcare Administration, Business Administration, Finance, or related field preferred.

Experience

• Minimum 5 years of medical billing and revenue cycle management experience.
• Minimum 2 years of supervisory or team leadership experience.
• Experience managing multi-specialty physician practice accounts preferred.
• Experience working for a medical billing company, RCM vendor, or physician management organization strongly preferred.

Knowledge & Skills

• Comprehensive knowledge of physician billing and revenue cycle operations.
• Strong understanding of CPT, ICD-10, HCPCS, and payer reimbursement methodologies.
• Experience with Medicare, Medicaid, commercial insurance, and managed care plans.
• Proficiency with practice management systems and EHR platforms.
• Advanced Excel and reporting skills.
• Strong analytical, organizational, and client-facing communication abilities.
• Ability to manage multiple client accounts simultaneously.

Preferred Certifications

• Certified Revenue Cycle Representative (CRCR)
• Certified Professional Biller (CPB)
• Certified Professional Coder (CPC)

Key Success Metrics

• Achieve or exceed client collection goals.
• Maintain A/R days within target benchmarks.
• Improve first-pass claim acceptance rates.
• Reduce denial volumes and aged receivables.
• Meet client service level agreements (SLAs).
• Maintain high client satisfaction and retention rates.
• Achieve team productivity and quality standards.