Description

We are seeking an experienced and results-driven Medical Billing & Coding Manager / Revenue Cycle Manager to own and manage the complete end-to-end Revenue Cycle Management (RCM) function. This role requires a seasoned professional with 10–12 years of experience in medical billing, coding, and healthcare operations across diverse practice settings. 

The ideal candidate will lead teams, streamline workflows, ensure compliance, and drive revenue optimization while maintaining full accountability for the financial performance of the revenue cycle.

Key Responsibilities: 

• Own and manage the complete end-to-end Revenue Cycle Management (RCM), including patient registration, insurance verification, charge capture, coding, billing, claims submission, payment posting, denial management, appeals, and AR follow-up  
• Lead, hire, train, and scale the medical billing and coding team, ensuring high performance and accountability  
• Drive optimization of the entire revenue cycle workflow to maximize collections and minimize revenue leakage  
• Ensure strict adherence to HIPAA compliance and other healthcare regulations  
• Oversee credentialing and provider enrollment with insurance payers to ensure uninterrupted billing operations  
• Supervise insurance verification processes to improve claim accuracy and reduce denials  
• Manage claims lifecycle, including submission, tracking, denial analysis, and appeals resolution  
• Take full ownership of Accounts Receivable (AR) performance, including reducing aging and improving cash flow  
• Act as the primary point of contact for insurance companies, resolving complex reimbursement issues and escalations  
• Develop and implement standard operating procedures (SOPs) for efficient and compliant billing operations  
• Monitor updates in ICD-10, CPT, and HCPCS coding standards and ensure team adherence  
• Establish, track, and report on KPIs and performance metrics to continuously improve RCM outcomes  

Requirements

• Bachelor's degree in healthcare administration, Business, or related field (or equivalent experience)  
• 10–12 years of experience in medical billing, coding, and full-cycle Revenue Cycle Management  
• Proven experience in a leadership or managerial role, managing teams and operations  
• Strong knowledge of HIPAA regulations, payer policies, and compliance standards 
• Hands-on expertise in credentialing, insurance verification, claims management, AR, and appeals  
• Experience working with multiple specialties or healthcare practices  

Certifications (Preferred): 

• CPC (Certified Professional Coder)  
• CCS (Certified Coding Specialist)  
• CPB (Certified Professional Biller) or equivalent  

Key Skills: 

• Strong leadership and team-building capabilities  
• Excellent communication and negotiation skills with payers and stakeholders  
• Deep understanding of end-to-end RCM processes  
• Analytical mindset with the ability to interpret financial and operational data  
• Strong problem-solving and decision-making abilities  
• High attention to detail and process orientation  
• Proficiency in medical billing software and EHR/EMR systems  

Preferred Experience: 

• Experience managing billing operations across multiple specialties or group practices  
• Proven track record of scaling RCM operations and building teams from the ground up  
• Familiarity with US healthcare systems, payer mix, and reimbursement models