Revenue Cycle Manager, Client Performance

Company Overview TRIARQ Health partners with physicians by providing the expertise, services, infrastructure, and technologies necessary for independent doctors to thrive in the new, value-based healthcare economy. We strive to achieve healthcare’s Triple Aim through provider-led and patient-centered, value-based care programs and alliances. TRIARQ Health aims to align and address the value and quality of healthcare to consumers through value-based programming with payers and providers. Description Company Overview TRIARQ Health partners with physicians by providing the expertise, services, infrastructure, and technologies necessary for independent doctors to thrive in the new, value-based healthcare economy. We strive to achieve healthcare’s Triple Aim through provider-led and patient-centered, value-based care programs and alliances. TRIARQ Health aims to align and address the value and quality of healthcare to consumers through value-based programming with payers and providers. TRIARQ Health’s community of healthcare professionals and providers combine their expertise and capabilities to offer unique value-based, technology-enabled services to individuals and families. In order to affect change, TRIARQ Health was started with the belief that the future of healthcare services must be based upon demonstrated value and quality. The TRIARQ name and its mission are centered on health care reform’s Triple Aim of providing high quality healthcare at affordable costs to populations and communities, by Aligning incentives and Redesigning care delivery around Quality. TRIARQ Health seeks to accomplish this by delivering efficient practice services and value-based programs delivered through physician-led alliances. Position Overview The RCM Client Success Manager is responsible for managing and maintaining strong relationships with practices along with internal RCM leadership teams. The role manages and monitors billing team performance to ensure post-sale goals are met, combining the responsibilities of revenue cycle management (RCM) and client success to ensure optimal performance and satisfaction of post-sale goals. This position is critical to the success of the revenue cycle process. In conjunction with maintaining a successful relationship with practice providers and staff, the RCM Client Success Manager will contribute to the day-to-day operations on all issues related to revenue cycle functions, and will work with cross-functional teams to identify trends, implement process improvements, and monitor key performance indicators. This is an analytically demanding role. The successful candidate will work directly with raw claim-level data to diagnose root cause, will independently research payer policy and CMS guidance to resolve denial trends, and will be expected to build the analysis themselves rather than rely exclusively on pre-built reporting. The ideal candidate will have extensive healthcare industry knowledge, deep revenue cycle management experience, strong analytical capability, working command of payer and regulatory policy, and excellent communication skills, and will be self-motivated. Responsibilities Client Performance and Process Improvement Develop and implement practice-specific process improvement recommendations to secure positive results, and monitor performance for unfavorable trends. Maintain reimbursement-related key performance indicators for practices, setting and benchmarking revenue cycle goals (e.g., reducing Days in A/R, decreasing outstanding receivables, increasing first pass rate %). Enhance and standardize workflow processes throughout the revenue cycle to achieve consistency in maintaining critical success factors outlined in standard operating procedures. Manage and monitor billing team performance to ensure post-sale goals and service commitments are met. Analysis and Reporting Analyze claim-level and charge-level data to identify root cause of denials, payment variance, underpayment, and A/R aging concentration, and translate findings into specific corrective action. Analyze and interpret revenue cycle key performance indicators and other performance indicators to identify successes and areas of opportunity. Produce and analyze standard monthly reports and PowerPoint presentations to assist in the monthly forecast process. Provide written executive summaries, presentations, and key information to physicians and administrators. Payer Policy and Regulatory Research Research and interpret payer medical policy, coverage determinations, coding edits, and CMS guidance — including NCCI edits, LCDs and NCDs, and fee schedule updates — to determine the correct resolution path for denial trends. Monitor payer behavior and industry trends, including policy changes, edit implementations, reimbursement shifts, and prior authorization requirements, and proactively advise practices and internal teams on operational impact. Translate policy and regulatory findings into clear, defensible written positions for appeals, provider education, and client-facing communication. Relationship Ownership Hold primary ownership and accountability for customer satisfaction within assigned accounts. Build and maintain effective internal and external relationships, even when faced with challenging client relationships. Conduct strategic planning and operational performance review sessions with clients, and map business goals to the identified value-drivers framework. Demonstrate knowledge and credibility of TRIARQ software and services. Act as a problem solver and advocate for clients, identifying at-risk clients proactively and collaborating across operational lines to pursue solutions. Requirements Experience and Education Minimum of five (5) years of medical billing management experience. Bachelor’s degree in healthcare administration, business, or other related field, or equivalent experience. Analytical and Technical Advanced Excel proficiency required, including pivot tables, lookup functions, and the ability to build analysis from raw, unformatted data exports rather than pre-built reports. Demonstrated ability to work with large claim-level datasets to identify root cause of denials, payment variance, and A/R trends. Ability to analyze financial and operating information to facilitate decision-making. Strong working knowledge of all Microsoft applications (Word, Excel, PowerPoint). Comfort using AI tools to accelerate analysis, reporting, and documentation workflows preferred. Payer and Regulatory Knowledge Demonstrated ability to independently research and apply payer policy and CMS guidance, including NCCI edits, LCDs and NCDs, coverage criteria, and fee schedule methodology. Working knowledge of denial and remittance code sets (CARC/RARC) and the ability to connect denial patterns to underlying payer policy or edit changes. Ability to monitor and interpret payer and regulatory trends and communicate operational implications to non-technical audiences. Professional Skills Exceptional interpersonal skills and strong oral and written communication skills. Relationship management and negotiation skills. Ability to prioritize and manage multiple projects in a dynamic work environment. Project management and project coordination skills. Excellent problem-solving skills and strong attention to detail. Ability to work independently and collaboratively with a multi-disciplinary team. #J-18808-Ljbffr TRIARQ Health