Job Description — Revenue Cycle Manager (RCM Manager)
Reports to: Leadership (Dr. Murthy / Priyanka Ghosh-Murthy)
Type: Jacksonville, Onsite; Full-time, in-house.
Works with: Outside RCM vendors, clinical providers, and the Well&You ops team
COMPANY SUMMARY
Well&You is a fast growing multispeciality healthcare practice and medical brand, focusing on a wide range of advanced outpatient procedures that meet the diverse needs of our Florida community. We currently have 20,000 square feet of clinical space via three state-of-the-art medical clinics, office based labs, and ambulatory surgical centers. Our board-certified, fellowship-trained cardiologists, interventional pain and spine providers, wound and vascular specialists, and interventional radiologists specialize in treating complex heart, venous, arterial, and chronic disease conditions across our facilities. We also provide on-site advanced imaging, including ultrasound, CT/CT-FFR, and transcranial Doppler, integrated directly into patient care. As we grow our practice areas, add new providers, and expand facilities, we are seeking a skilled and experienced RCM leader to own and strengthen our revenue cycle as we scale by maximizing collections, ensuring billing accuracy and compliance, and holding our billing partners accountable.
ROLE SUMMARY
Well&You uses outside vendors for day-to-day billing across its service lines while keeping ownership and accountability for the revenue cycle in-house. The RCM Manager is the single internal owner of that function: part hands-on operator, part vendor auditor, part reporting analyst, and part internal-ops partner. The ideal candidate will make sure every outside vendor hits its commitments, that performance and data are consolidated into one trusted source of truth across all vendors and service lines, and that Well&You captures every dollar it is owed.
The role is explicitly AI-forward: Well&You builds its own reporting and automation tools, and this person is expected to use and extend them, and to operate effectively alongside AI-driven vendor platforms.
KEY RESPONSIBILITIES
- Own End to End Revenue Cycle
- Make sure claims go out expeditiously: hold vendors to the agreed billing-turnaround times, chase any case that is stuck, and track when providers are slow to close their notes
- Manage the vendors day to day: be the main point of contact for each outside vendor, run regular check-in meetings, require quick responses, and escalate anything that is at risk of slipping past its deadline.
- Keep billing set up correctly: maintain an accurate master list of the practice’s billing entities, provider IDs (NPIs), tax IDs, locations, and fee schedules; test and approve any new setup before the first claim goes out; and establish checklists with clear delineation of responsibilities when setup is needed (new insurance contract, new provider, new location, new procedure, new accreditation).
- Hold the right party accountable for claims: track every denied or partially denied claim, identify why it happened, and assign it to whoever is responsible; require vendors to fix and resubmit their own errors quickly
- Oversee coding quality: ensure each vendor’s coders are properly certified for the work they handle, audit their coding regularly, and use pre-procedure checklists so the documentation supports the codes billed (preventing denials before they happen).
- Manage denials and appeals: keep a running log of why claims are denied and a tracker so no appeal deadline is missed; flag problem insurer/procedure combinations early; and make sure the practice is paid the full contracted amount, not less.
- Own the reporting: build and maintain one trusted set of reports across all vendors (collections, aging, denials, dollars at risk, a monthly ‘what changed and why’ summary, and procedure profitability) and deliver a monthly summary to leadership.
- Coordinate coding questions to providers: be the single channel for coding questions from vendors to physicians, keep them organized and documented, and give providers a monthly summary of recurring documentation issues.
- Do Well&You’s part on time: make sure the practice delivers what vendors need to do their job (op notes and implant records, daily deposits, forwarded denials, timely approvals, refunds) so an internal delay never becomes the vendor’s excuse.
- Seamless, optimized revenue cycle: via management of multiple systems, billing vendors, and related contracts to ensure a seamless, optimized revenue cycle, clearly define vendor responsibilities, and prevent duplicate collection-based payments.
- Stay ahead of prior authorizations and medical-necessity rules: make sure every procedure has the required authorization in place beforehand and work with billers to ensure that documentation checks/controls for medical necessity meet each payer's coverage rules (Medicare LC/NCD and commercial policies).
- Capture what patients owe: with high-deductible plans and imaging/procedure copays in our OBL and ASC settings, make patient and point-of-service collections a real priority, verify responsibility up front, collect at the time of service where possible, and follow up so this meaningful share of revenue isn't lost.
KEY QUALITIES
- Problem Solver: Proactive problem-solver with a solutions-oriented mindset.
- Agile: Creative and adaptable to a fast-paced, iterative environment
- Accountable: Takes ownership of tasks; ensures quality and timeliness
- Ambitious: Driven by progress and growth for organization, team, and self
- Calm & Unflappable: Not overwhelmed by competing demands and multitasking
- Clear Communicator: Strong, clear, and concise verbal and written communication, understood at all levels.
- Empathetic: Understands others' perspectives, fosters meaningful connections.
- Driven to Excellence: Hardworking and gritty; driven to no less than excellence
- Humility: Displays modesty in success, recognizes contributions of others.
- Integrity: Upholds highest personal integrity and personal/professional ethics.
- Intellectually Curious: Eager to learn new topics; resourceful and quick learner.
- Leader: Is able to manage and lead internal stakeholders and outside vendors
- Open-Minded: Welcomes new ideas and innovative and diverse thinking.
- Respectful: Treats all stakeholders all levels with courtesy and dignity
- Self-Starter: Action oriented; can operate with little direction and supervision
- Strategic Thinker: Attentive to detail yet keeps main goals/big picture in mind
- Teamworker: Collaborates effectively with others and prioritizes team goals
- Trustworthy: Strong, trusting relationships via dependability and consistency.
HOW THIS ROLE IS MEASURED (TOPLINE KPIS)
- Net collection rate ≥ 97% (collected ÷ contractual allowed, net of approved write-offs)
- Days in A/R < 40 (ASC < 35); A/R > 90 days < 15%
- First-pass clean-claim rate ≥ 95%
- Denial rate < 5–8%; appeal overturn ≥ 50%
- Charge lag ASC < 24h; OBL/Clinic/Imaging < 48h
REQUIRED EXPERIENCE & QUALIFICATIONS
- 5+ years in healthcare revenue cycle, with hands-on billing, denials, and AR follow-up experience.
- Strong knowledge of physician/professional and facility (ASC) billing across clinic, office-based lab (OBL), and imaging settings, including payer rules, NCCI edits, modifiers, and contract allowables; coding credential (CPC/COC) or close working knowledge of coding.
- Experience managing or auditing outsourced RCM vendors and holding them to SLAs.
- Proficiency with eClinicalWorks (eCW), plus strong Google sheet/spreadsheet skills.
- Familiarity with clearinghouse operations and payer enrollment/credentialing.
- Multi-specialty experience, i.e. vascular, interventional cardiology, electrophysiology, pain & spine, wound care, podiatry, imaging, and remote patient monitoring
- Ideal experience at ASC, hospital, and larger private clinical practice
- Experience building and interpreting RCM reports, e.g. first-pass, A/R aging, denial trends, net collection rate and translating them into action and dollars.
REQUIRED AI COMPETENCIES
- Comfortable using AI tools: uses AI day-to-day to build reports, draft and automate routine work, and analyze billing data; quick to learn and adopt new AI tools.
- Knows AI’s limits: treats AI as a helper, not the final word; double-checks what it produces and understands where it tends to make mistakes.
- Can guide AI: gives clear, specific instructions to get reliable, repeatable results, and improves them over time.
- Works comfortably with AI-based vendor systems: can use and oversee AI-driven billing tools, check their output, and trust but verify.
- Automation mindset: looks for manual, repetitive tasks and turns them into faster AI-assisted workflows, helping the practice do more in-house over time.
SALARY & BENEFITS
- Base salary: $105,000–$115,000, commensurate with experience
- Performance bonus: up to 10–15% of base, tied to revenue-cycle KPIs: net collection rate, days in A/R, first-pass clean-claim rate, denial/appeal performance, and charge lag.
- Growth upside: Eligibility for a discretionary growth, profit-share bonus, and equity as the practice expands.
- Benefits: Health coverage, paid time off, and standard practice benefits (details provided during the interview process).
Work Location: In person
