Revenue Cycle Management Manager

This role is only for candidates with direct out-of-network behavioral health revenue cycle management experience. We are looking for someone who can manage a 5-person team, improve KPIs, train junior staff, and personally handle complex payer escalations. Candidates without OON behavioral health experience will not be considered.

To confirm you have read the full job description, please title your email “OON Behavioral Health RCM.” In your application, also describe your direct OON behavioral health experience, how many people you have managed or trained, and one revenue cycle KPI you improved. Applications that do not use this email title or do not address the required experience will not be reviewed.


Key Responsibilities
Manage daily revenue cycle operations, including billing, collections, AR follow-up, denials, appeals, low-pay disputes, and payment posting.
Supervise a 5-person RCM team, including setting priorities, monitoring productivity, reviewing work quality, and holding staff accountable.
Train junior tea ---------- mbers on billing workflows, payer portals, claim follow-up, documentation standards, appeals, and escalation procedures.
Manage out-of-network commercial behavioral health claims, including delayed claims, denials, underpayments, and payer disputes.
Track and improve key RCM KPIs, including collections, AR aging, denial rate, clean claim rate, unworked claims, days in AR, underpayments, appeal outcomes, and team productivity.
Use KPI reporting to identify bottlenecks, payer issues, staff training needs, and process improvement opportunities.
Identify payer issues and escalate through appeals, provider relations, plan administrators, state insurance departments, DOL complaints, or other regulatory channels as appropriate.
Ensure claim notes and payer communications are documented clearly and consistently.
Work with utilization review, admissions, clinical, and finance teams to resolve reimbursement issues.
Support month-end close with accurate AR, collections, payer updates, and KPI reporting.
Improve workflows to reduce avoidable denials, shorten AR timelines, and increase collections.

Required Qualifications
Direct behavioral health revenue cycle experience.
Direct out-of-network commercial payor experience in behavioral health is required.
Experience managing or supervising RCM staff.
Experience tracking, reporting, and improving revenue cycle KPIs.
Strong knowledge of billing, AR follow-up, denials, appeals, low-pay disputes, and payment posting.
Experience with payer escalation and regulatory complaints when payors fail to comply with applicable rules or obligations.
Ability to train junior staff and create accountability around daily productivity.
Strong written communication and documentation skills.
Ability to identify payer-specific issues and drive them to resolution.

Preferred Qualifications
Experience with major commercial payors, including BCBS, Aetna, Cigna, UHC/Optum, UMR, and TPAs.
Experience with major commercial federal payors including TriCare and VA
Familiarity with ERISA, self-funded plans, state insurance complaints, DOL complaints, or similar escalation processes.
Experience with behavioral health billing systems, clearinghouses, payer portals, and KPI dashboards.
Strong Excel Experience

Success Measures
Improved collections and AR follow-up discipline.
Reduced unworked claims and avoidable denials.
Clearer accountability and productivity management across the team.
Stronger training and development of junior staff.
Better tracking and improvement of RCM KPIs.
Faster escalation of payer issues and underpayments.
Better visibility into AR, denials, payer trends, staff productivity, and expected cash.