Deputy, RCM

Key Responsibilities

Client Management & Communication

• Support the RCM leadership team in managing assigned client accounts and day-to-day client requirements.
• Act as a secondary point of contact for clients and provide coverage in the absence of the primary client lead.
• Participate in weekly, monthly, and quarterly client meetings and operational reviews.
• Prepare meeting agendas, performance summaries, action trackers, and follow-up communications.
• Ensure client questions, concerns, and escalations are acknowledged and resolved within agreed timelines.
• Coordinate with internal teams to provide accurate and timely updates to clients.
• Build strong working relationships with client stakeholders and internal functional teams.

RCM Operations Management

• Monitor end-to-end revenue cycle performance across assigned clients.
• Coordinate activities across Coding, Charge Entry, Claims, AR, Denials, Payment Posting, Prior Authorization, Eligibility, Enrollment/Credentialing, and Patient Accounts.
• Identify operational gaps affecting collections, claim submission, reimbursement, or client satisfaction.
• Ensure appropriate follow-up on high-dollar claims, aged AR, unresolved denials, and payer-related issues.
• Track operational dependencies and ensure issues are assigned to appropriate teams for resolution.
• Support new client implementations, system transitions, payer changes, and operational workflow changes.

KPI & Performance Management

Monitor and analyze key RCM metrics, including:

• Days in AR
• AR aging, particularly 90+ and 120+ AR
• Gross and net collections
• Charge and payment trends
• Denial rate and denial trends
• Clean claim / first-pass acceptance rate
• Claim submission turnaround time
• Coding turnaround time
• Payment posting turnaround time
• Average claim touches
• Productivity and quality
• Prior authorization performance
• Enrollment and credentialing-related claim holds

Identify negative trends early and work with operational teams to develop corrective action plans.

AR & Denial Management

• Review AR aging and identify opportunities for accelerated collections.
• Monitor high-dollar and aged accounts requiring escalation.
• Analyze denial trends by payer, provider, CPT, denial reason, and root cause.
• Coordinate with Coding, Enrollment, Authorization, and AR teams to resolve recurring denial issues.
• Monitor timely filing limits and ensure claims at risk are prioritized appropriately.
• Track appeals, reconsiderations, corrected claims, and payer escalations through resolution.
• Support initiatives to reduce rework and prevent avoidable denials.

Reporting & Analytics

• Prepare weekly and monthly operational dashboards and client performance reports.
• Analyze charge, payment, adjustment, denial, and AR trends.
• Validate data before presenting reports to clients or leadership.
• Highlight performance improvements, risks, root causes, and action plans.
• Provide meaningful insights rather than simply reporting metrics.
• Maintain trackers for escalations, payer issues, client requests, and outstanding action items.

Cross-Functional Coordination

Work closely with:

• AR & Denials
• Coding
• Charge Entry
• Payment Posting
• Prior Authorization
• Eligibility
• Enrollment/Credentialing
• Patient Services
• Quality
• Training
• IT/Development
• Client Success
• RCM Leadership

Ensure cross-functional dependencies are identified, communicated, tracked, and resolved without negatively affecting client performance.

Escalation Management

• Identify operational and client risks before they become major escalations.
• Maintain ownership of escalated issues until closure.
• Coordinate root-cause analysis for recurring operational issues.
• Escalate high-risk items to RCM leadership with supporting data and recommended next steps.
• Maintain clear documentation of decisions, action items, owners, and expected completion dates.

Process Improvement

• Identify opportunities to improve productivity, quality, collections, and turnaround times.
• Support workflow standardization and automation initiatives.
• Work with leadership and technology teams to reduce manual processes and unnecessary claim touches.
• Participate in root-cause analysis and corrective/preventive action initiatives.
• Support implementation of operational best practices across multiple client accounts.

Required Skills & Competencies

• Strong understanding of U.S. healthcare Revenue Cycle Management.
• Knowledge of physician/professional billing processes.
• Strong understanding of AR, denials, claims, coding, payment posting, eligibility, authorization, and enrollment workflows.
• Knowledge of Medicare, Medicaid, Commercial, Workers' Compensation, and Medicare Advantage payer processes.
• Strong analytical and problem-solving skills.
• Ability to interpret operational and financial RCM reports.
• Strong written and verbal communication skills.
• Ability to communicate confidently with clients and senior leadership.
• Strong ownership and follow-through.
• Ability to manage multiple clients, priorities, and deadlines simultaneously.
• Advanced working knowledge of Excel and reporting tools.
• Experience working with practice management systems, clearinghouses, and payer portals.

Software / Practice Management System Knowledge

The candidate should have hands-on experience working with multiple Practice Management (PM) and Electronic Health Record (EHR) platforms, including:

• eClinicalWorks (eCW)
• Tebra
• Cerner
• athenahealth (Athena)

The candidate should be comfortable navigating these systems for charge review, claim status, AR follow-up, denial management, payment review, reporting, and account-level analysis.

Specialty Experience

Preferred experience supporting:

• Primary Care / PCP
• Multi-Specialty Physician Practices

Experience should include an understanding of specialty-specific billing workflows, payer requirements, coding dependencies, authorization requirements, denial trends, and reimbursement challenges.

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