Senior Manager - RCM

Senior Manager, Revenue Cycle Management (RCM)

Position Summary

The Senior Manager of Revenue Cycle Management (RCM) oversees day-to-day revenue cycle operations for a multi-site optical organization, supporting both clinical (optometry) and retail optical services. This role is responsible for driving efficient billing, coding, collections, and reimbursement processes while improving cash flow, ensuring compliance, and enhancing the patient financial experience. The Senior Manager also manages relationships and performance of third-party billing vendors.

Key Responsibilities

Revenue Cycle Operations

• Manage daily RCM functions including registration, insurance verification, coding, charge capture, billing, collections, and denial resolution
• Oversee both medical and vision insurance workflows
• Ensure timely and accurate claim submission, payment posting, and follow-up
• Monitor team productivity, work queues, and service levels

Vendor Management

• Oversee third-party billing companies and outsourced RCM partners
• Establish performance expectations, KPIs, and SLAs; monitor vendor performance against targets
• Conduct regular business reviews and resolve escalations, quality issues, and underperformance
• Partner with vendors to improve processes, reduce denials, and maximize collections

Financial Performance

• Track and analyze KPIs (A/R days, denial rates, clean claim rate, collection ratios)
• Identify revenue leakage and implement corrective actions
• Support initiatives to improve cash flow and reduce write-offs
• Prepare and present performance reports for leadership

Compliance & Quality

• Ensure adherence to payer guidelines and regulatory requirements 
• Support coding accuracy through audits and staff/vendor education
• Assist with internal and external audits

Team Leadership

• Lead, coach, and develop internal RCM staff
• Drive accountability, performance management, and continuous improvement
• Support hiring, onboarding, and training

Systems & Process Improvement

• Identify workflow inefficiencies and implement process improvements
• Support optimization of practice management systems, EHR, and billing platforms
• Assist with system enhancements and technology implementations

Cross-Functional Collaboration

• Partner with clinical, retail, and front-end teams to ensure accurate data capture and billing readiness
• Provide guidance on insurance processes and documentation requirements

Qualifications

Education & Experience

• Bachelor’s degree preferred (Healthcare Administration, Business, Finance, or related)
• 5–8+ years of RCM experience with 2–4+ years in a supervisory role
• Experience in optical, optometry, ophthalmology, or retail healthcare preferred

Knowledge & Skills

• Strong knowledge of medical and vision billing, coding (CPT, ICD-10, HCPCS), and payer guidelines
• Experience managing third-party billing vendors or outsourced RCM functions
• Data-driven with strong analytical and problem-solving skills
• Experience with practice management systems and EHR platforms
• Excellent communication and leadership abilities