RCM Manager at Paradigm Oral Surgery
United States
<div><table border="1" cellspacing="0" cellpadding="0" summary="6 stacked tables: First table is for entering Job Title, Department or Group, Location, Level or Salary range, HR contact, Will Train Applicant. Second table is for entering url details. Third table is the Applications Accepted By heading. Fourth table is for entering Applications Accepted By information. Fifth table is for Job Description with the heading and a row to enter Job Description information. Sixth table is for Reviewed By, Approved By, and Last Updated By" width="624" style="border-collapse: collapse;border: none;width: 624px;" data-pasted="true"><tbody><tr><td valign="top" style="width: 23.0769%; border: 1pt solid windowtext; background: rgb(242, 242, 242); padding: 1.45pt 5.75pt; vertical-align: top;"><h2 style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;font-weight:bold;'><span style="color:black;">Job Title:</span></h2></td><td valign="top" style="width: 29.8077%; border-top: 1pt solid windowtext; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-image: initial; border-left: none; padding: 1.45pt 5.75pt; vertical-align: top;"><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;'>RCM Manager - Regional</p></td><td valign="top" style="width: 19.2308%; border-top: 1pt solid windowtext; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-image: initial; border-left: none; background: rgb(242, 242, 242); padding: 1.45pt 5.75pt; vertical-align: top;"><h2 style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;font-weight:bold;'><span style="color:black;">Reports To:</span></h2></td><td valign="top" style="width: 27.8846%; border-top: 1pt solid windowtext; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-image: initial; border-left: none; padding: 1.45pt 5.75pt; vertical-align: top;"><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;'>Director Revenue Cycle Management</p></td><td style="border: none; padding: 0in; width: 0%;"><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;'><br></p></td></tr><tr><td valign="top" style="width: 23.0769%; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; background: rgb(242, 242, 242); padding: 1.45pt 5.75pt; vertical-align: top;"><h2 style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;font-weight:bold;'><span style="color:black;">Location:</span></h2></td><td valign="top" style="width: 29.8077%; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 1.45pt 5.75pt; vertical-align: top;"><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;'>Remote</p></td><td valign="top" style="width: 19.2308%; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; background: rgb(242, 242, 242); padding: 1.45pt 5.75pt; vertical-align: top;"><h2 style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;font-weight:bold;'><span style="color:black;">Last Updated:</span></h2></td><td valign="top" style="width: 27.8846%; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 1.45pt 5.75pt; vertical-align: top;"><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;'>1/19/2026</p></td><td style="border-top: none; border-right: none; border-left: none; border-image: initial; border-bottom: 1pt solid windowtext; width: 0%;"><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;'><br></p></td></tr><tr><td colspan="5" valign="top" style="width: 100%; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; padding: 1.45pt 5.75pt; vertical-align: top;"><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:"Calibri",sans-serif;font-weight:bold;'>ROLE OVERVIEW</h1><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:0in;margin-bottom:1.5pt;vertical-align:baseline;'><span style="font-size:12px;font-family:Calibri;">The Revenue Cycle Management (RCM) Regional Manager is responsible for overseeing all revenue cycle operations for a defined region within Paradigm Oral Health. This role provides direct leadership to multiple RCM supervisors and clinic-aligned billing and AR teams, ensuring consistent execution of centralized RCM workflows while maintaining strong operational alignment with individual practices.</span></p><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:0in;margin-bottom:1.5pt;vertical-align:baseline;'><span style="font-size:12px;font-family:Calibri;">The Regional RCM Manager is accountable for regional performance across medical and dental billing, collections, denial management, and patient balances, with a focus on driving results, standardizing processes, and escalating systemic issues for resolution at the enterprise level.</span></p><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:0in;margin-bottom:1.5pt;vertical-align:baseline;'><span style="font-size:12px;font-family:Calibri;">The successful candidate will demonstrate strong ability to collaborate with various departments, ensure compliant and scalable processes, communicate with insurance providers, provide seamless central support for offices, and elevate the patient financial experience. Comfort communicating with Operations leadership and oral surgeons is crucial for success in this role. </span></p><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:0in;margin-bottom:1.5pt;vertical-align:baseline;'><strong> </strong></p><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:0in;margin-bottom:1.5pt;vertical-align:baseline;'><strong><span style='font-size:15px;font-family:"Calibri",sans-serif;'>KEY RESPONSIBILITIES:</span></strong></p><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;'><ul style="margin-bottom:0in;list-style-type: disc;margin-left: -0.25in;"><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Oversee and manage the RCM teams supporting the assigned Region. Lead, coach, and develop RCM supervisors and team members across all RCM functions and practice support models. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Responsible for at least the following functions: insurance verification, billing, statement generation, insurance follow-up, collections placement, cash posting, office escalations and patient inquiries, and others. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Review and “spot check” claims, statements, and other staff activities to evaluate if work product is produced efficiently and effectively, documenting any trends that need improvements. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Ensure compliance with federal and state billing regulations; CMS, commercial payer, and dental payer requirements; as well as No Surprises Act, prompt-pay rules, and payer notification standards</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Provide support to all team members as needed for arising situations (i.e field questions, practice relations, employee interactions, etc)</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Continuously evaluate RCM processes to identify inefficiencies or areas for improvement. Propose and implement strategies to streamline workflows and improve the net collection rate, reduce days in AR, and lower the percentage of AR over 90 days. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Schedule, plan, and run team meetings to discuss accounts, goals, and improvements. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Provides education and training for new and existing staff members</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Completes corrective action meetings including verbal or written warnings with assistance from Human Resources</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-family:Calibri;font-size:12px;">RCM Ticketing and Teams Communication: Review speed and effectiveness of resolution of practice needs, account questions, and communication back to practice and/or patient. Ensure response time follows SLA and appropriately addresses initial ask. </span> </li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-family:Calibri;font-size:12px;">Audit team performance weekly and ensure that all RCM activities are processed in a timely, accurate, and compliant manner according to SOP and KPIs per role, holding team members accountable to target metrics. </span> </li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Collaborate with other departments, such as finance, operations, credentialing, and clinical teams, to drive alignment and coordination across the revenue cycle continuum. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Set clear performance expectations, accountability structures, and career development pathways for team members. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Foster a culture of collaboration and communication to support organizational objectives.</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Provide feedback to RCM Director and VP to support quarterly and annual performance reviews for all team members. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">RCM Ticketing: Review speed and effectiveness of resolution of practice needs, account questions, and communication back to practice and/or patient. Ensure response time follows SLA and appropriately addresses initial ask. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Partner with Compliance and Legal teams on audits, payer reviews, and corrective action plans.</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Ensure teams are appropriately staffed in relation to volume-based staffing model per regional practice, and role alignment per team member is positively impacting RCM metrics. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Review trends MoM to assist in setting departmental goals related to RCM metrics and provide input into strategic initiatives aimed at improving financial performance. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Report any compliance concerns to RCM Director or VP, and assist with resolution of compliance issues or discrepancies, working closely with the compliance department as needed. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Act as point of escalation for site leadership when account or patient questions arise. Coordinate research with appropriate role-specific team member and review outcomes with site leadership and/or direct manager. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Develop and maintain strong relationships with the practice operations team, practice administrators, and surgeons from support practices. Understand their businesses and preferred methods of central RCM support to provide an effective and functional services relationship. </span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Other duties and responsibilities as assigned by leadership</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Key RCM metrics:</span></li></ul></div><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;'><ul style="margin-bottom:0in;list-style-type: circle;margin-left: 0.25in;"><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Days in A/R – total and by payer type</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">A/R Aging – 90 and 120+</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Clean Claims Rate</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Rejection Rate</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">First-pass payment rate</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Net Collection Rate</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Credit balance resolution</span></li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;"><span style="font-size:12px;">Cost-to-collect</span></li></ul></div><p style='margin-right:0in;margin-left:.25in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;text-indent:0in;'><br></p><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:"Calibri",sans-serif;font-weight:bold;margin:0in;'>ESSENTIAL QUALIFICATIONS:</h1><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:"Calibri",sans-serif;font-weight:bold;margin:0in;'><br></h1><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;'><ul style="margin-bottom:0in;list-style-type: disc;margin-left: -0.25in;"><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;">Prior experience in Dental Office workflows, Revenue Cycle functions to include Scheduling, Registration, Insurance verification, fee schedules, claim submission, charging/coding requirements, insurance AR follow up and payment posting process</li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;">Must be knowledgeable of reimbursement/compliance process and procedures with all payors</li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;">Experience with practice management software systems, insurance portals, clearing houses, insurance guidelines, banking reconciliation software, proficient in intermediate PC skills (MS Office—strong excel skills). Strong computer literacy, Excellent Math and problem-solving skills. Data entry and 10-key by touch.</li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;">Strong interpersonal and organization skills. Ability to work within a team setting and as an individual contributor. Excellent oral and written communication skills</li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;">Responsible for quality work, meeting deadlines, and adherence to Compliance and Revenue cycle standard operating procedures</li><li style="margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family: initial;">Organized work habits, accuracy, and proven attention to detail with strong analytical skills</li></ul></div><p style='margin-right:0in;margin-left:.25in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;text-indent:0in;'><br></p></td></tr></tbody></table><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:"Calibri",sans-serif;margin-top:1.5pt;margin-bottom:0in;'><br></p></div>
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