A1advisor

<p><b>Industry &amp; Sector</b><br>A fast-moving organization operating in the US Healthcare Revenue Cycle Management (RCM) sector, delivering end-to-end billing, claims management, and reimbursement optimization services for provider organizations and payers. This role supports distributed, remote teams focused on maximizing cash recovery, reducing denials, and improving payer performance across Medicare, Medicaid and commercial lines.</p>
<p><b>Primary Job Title (standardized):</b> Revenue Cycle Manager — US Healthcare</p>
<h3>About the Opportunity</h3>
<p>We are hiring a Revenue Cycle Manager to lead and scale US-focused RCM operations in a fully remote environment. You will own operational performance across claims submission, AR, denials, and payer follow-up while implementing process improvements and KPI-driven controls that accelerate cash flow and reduce days in A/R.</p>
<h3>Role &amp; Responsibilities</h3>
<ul>
<li>Drive end-to-end revenue cycle operations: oversee claims processing, payer follow-up, AR aging, and denial resolution to meet monthly cash and A/R targets.</li>
<li>Design and implement standardized workflows, SLA frameworks, and KPI dashboards for remote billing and follow-up teams.</li>
<li>Lead denial management and appeal strategies—identify root causes, implement corrective action, and reduce denial rates.</li>
<li>Partner with coding, clinical and IT teams to improve charge capture, claims accuracy, and timely submission using Epic/Cerner/Athena or equivalent systems.</li>
<li>Manage vendor and clearinghouse relationships to resolve adjudication issues and optimize remittance posting and ERA processes.</li>
<li>Coach, mentor and performance-manage a distributed team; recruit and scale resources to meet volume and quality goals.</li>
</ul>
<h3>Skills &amp; Qualifications</h3>
<p><b>Must-Have</b></p>
<ul>
<li>Proven experience managing US healthcare revenue cycle operations (billing, AR, denials, payer follow-up) in a remote or hybrid model.</li>
<li>Operational expertise with one or more major RCM platforms (Epic, Cerner, Athenahealth, Meditech).</li>
<li>Deep knowledge of medical billing, claims adjudication, AR aging analysis and denial management best practices.</li>
<li>Strong working knowledge of ICD-10 and CPT coding implications on claims and reimbursement.</li>
<li>Proven ability to define and track RCM KPIs (Days in A/R, Clean Claim Rate, Denial Rate, Net Collections).</li>
<li>HIPAA compliance awareness and familiarity with payer rules across Medicare, Medicaid and commercial insurers.</li>
</ul>
<p><b>Preferred</b></p>
<ul>
<li>Professional certification such as CPB, CPMA or CPC.</li>
<li>Experience with Change Healthcare/RelayHealth clearinghouse integrations and ERA reconciliation workflows.</li>
<li>Background in value-based reimbursement models and contract reconciliation.</li>
</ul>
<h3>Benefits &amp; Culture Highlights</h3>
<ul>
<li>Fully remote role with flexible hours to support distributed US operations.</li>
<li>Autonomy to build processes, influence technology adoption, and scale high-performing teams.</li>
<li>Performance-driven culture focused on continuous improvement, data-backed decisions, and measurable impact on cash flow.</li>
</ul>
<p>Apply if you are a results-oriented RCM leader who can translate payer rules and system configurations into measurable improvements in collections, denials reduction, and operational efficiency across US healthcare payers.</p>