Manager of Revenue Cycle Management

About the Company

Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care. We offer a broad scope of services including multispecialty physician services, telemedicine, and remote patient monitoring.

Responsibilities

• Lead and manage revenue cycle operations including billing, holds/credentialing, denials, collections, and accounts receivable management
• Develop and implement KPIs, policies, and procedures to ensure accurate claim submission and reduce denials
• Analyze trends impacting charges, coding, collection, and accounts receivable to realign staff and vendors
• Identify and resolve revenue cycle issues such as coding errors, inaccurate patient information, and insurance prioritization
• Monitor metrics including AR aging, claim submission, payment turnaround times, and denial rates
• Spearhead resolution of rejected or underpaid claims through targeted appeals and payer negotiations
• Supervise, mentor, and evaluate offshore RCM teams and third-party vendors
• Ensure compliance with regulatory requirements including HIPAA

Requirements

• 7+ years of experience in healthcare revenue cycle management
• Vast CPT and ICD-10 expertise
• Strong knowledge of credentialing and payor management
• Proficient background in reimbursements and monitoring clearinghouse activity
• Experience setting up payors with EDI, ERA, and EFT processes
• Experience managing and leading a team of revenue cycle professionals
• Proficiency with eClinicalWorks, Monday, Slack, Google Suite, Excel, Zoom, and MS Teams

Benefits

• 401k with Employer Match
• Health, Dental, and Vision Insurance
• PTO and Holiday Pay
• Employer Paid Life insurance Policy
• Short and Long-Term Disability Insurance
• Company Provided Equipment
• Employee Assistance Program (EAP)