RCM Manager

Role Overview

Sunshine Pediatric & Family Clinic is looking for an experienced RCM Manager to lead and manage our U.S.

healthcare revenue cycle operations. The RCM Manager will be responsible for ensuring timely reimbursement,

reduction of outstanding AR, effective denial management, accurate billing workflows, and strong team

performance.

Key Responsibilities

• Manage day-to-day RCM, billing, AR, and denial management operations.
• Monitor AR aging, with special focus on 60+, 90+, and 120+ outstanding claims.
• Identify unpaid, underpaid, rejected, and denied claims and ensure timely resolution.
• Analyze recurring denials and implement root-cause corrective actions.
• Monitor payer-specific issues and escalate unresolved reimbursement problems.
• Ensure accurate and timely claim submission, follow-up, appeals, and corrected claims.
• Track expected vs. actual payments and identify potential underpayments and revenue leakage.
• Manage and monitor RCM team productivity, quality, and accountability.
• Conduct regular audits and provide training/coaching where performance gaps are identified.
• Develop and improve RCM workflows, SOPs, trackers, and automation.
• Coordinate with clinical, front-office, credentialing, and other teams when their workflows impact reimbursement.
• Provide management with clear reporting on AR, collections, denials, outstanding issues, and action plans.

What We Are Looking For

• Strong experience in U.S. Healthcare RCM / Medical Billing.
• Previous experience managing an RCM or AR team.
• Strong knowledge of AR follow-up, denials, claim processing, EOB/ERA analysis, appeals, and payer workflows.
• Ability to independently analyze complex billing and reimbursement issues.
• Strong Excel/Google Sheets and reporting skills.
• Excellent leadership, communication, and problem-solving skills.
• Experience with eClinicalWorks (eCW) is preferred