Revenue Cycle Management (RCM) Supervisor Retina Specialists of Michigan - 4.8 Grand Rapids, MI Job Details Full-time 1 day ago Benefits Health savings account Health insurance Dental insurance 401(k) Paid time off Vision insurance 401(k) matching Life insurance Qualifications Revenue cycle management Staff supervision Teamwork Healthcare staff management Team supervision High school diploma or GED Supervising experience Bachelor's degree Bachelor of Business Administration Medical billing Business Administration Associate's degree Leadership Time management

Full Job Description Physical Demands Initiative & Accountability Company Overview:

As West Michigan's only privately owned retina practice, Retina Specialists of Michigan is a rapidly growing retina-only medical practice with an expanding team of 10 physicians and 100 employees committed to making a meaningful impact on the lives of those we serve. Our mission is anchored by five core values that guide our daily work and future growth: show respect, do the right thing, aim for excellence, be curious, and elevate each other.

Position Overview:

The RCM Supervisor is the accountable owner of the revenue cycle team(s) at Retina Specialists of Michigan. This seat exists to lead, manage, and hold accountable both the internal billing, prior authorization, and patient assistance team and an external billing company, ensuring full execution of RSM's RCM Optimization Plan. The RCM Supervisor closes the gap between strategy and daily operations — driving clean claim performance, maximizing collections, eliminating preventable losses (particularly drug-related), and delivering the financial transparency required for RSM's continued growth. This role demands independent thinking and genuine curiosity. The RCM Supervisor is expected to proactively dig into data, payer portals, system reports, and workflows without waiting to be directed, uncovering inefficiencies, identifying root causes, and bringing forward concrete recommendations for improvement or optimization. This seat is expected to continuously refine RSM's systems, workflows, and processes for untapped opportunity, surfacing what others may overlook and translating findings into actionable recommendations. Success in this role is equally measured by the performance and development of the team(s) under this seat's supervision, ensuring individuals are clear in their roles, held accountable to defined expectations, and growing in their capacity to execute. This role operates within the Entrepreneurial Operating System (EOS) framework, with defined seat expectations that promote accountability, collaboration, and alignment with RSM's goals.

Responsibilities and Duties:

Lead, Manage & Hold Accountable — Internal Team & External Billing Partner Serve as the direct supervisor for the internal billing team, providing clarity of role, consistent feedback, and performance accountability Serve as RSM's primary point of contact and relationship owner with external billing company, holding the external team accountable to defined workflows, KPIs, and timelines Facilitate regular team meetings (internal and joint) to surface issues, review metrics, and drive resolution Ensure all roles and responsibilities across RSM and billing company are documented, understood, and executed within defined timelines (45/60/90-day milestones per RCM Optimization Plan) Identify staffing gaps or performance issues and escalate recommendations to leadership Champion RSM's core values and EOS operating principles across all RCM functions Performance Management & KPI Accountability Own the monthly KPI reporting package — including Days in A/R, Net Collection Rate, Clean Claim Rate, Denial Rate, Charge/Claim Submission Lag, and Drug (HCPCS) A/R metrics Deliver KPI scorecards on defined cadence with variance analysis and corrective action plans Require and review root cause analysis from billing company and internal team when performance falls below benchmark Maintain corrective action tracking and escalate persistent issues to leadership Monitor and report on payer mix quarterly at practice, physician, and location level Conduct annual

CPT/HCPCS

utilization analysis (top 80-85% of billed codes) and annual payer fee schedule analysis Support annual performance summary to physician partners A/R Management, Denial Resolution & Drug Revenue Protection Oversee all A/R management — professional services and drug (HCPCS) — ensuring timely claim follow-up, denial resolution, and underpayment recovery Monitor drug A/R through RetinaOS weekly; identify and escalate unbilled, unpaid, and underpaid drug claims in real time Drive target of zero preventable drug write-offs through disciplined pre-service controls and real-time escalation Serve as escalation point for authorization denials, timely filing risks, and material A/R variances Oversee patient collections workflow from statement cycle through collection agency transfer — ensuring consistent, systemized escalation with minimal case-by-case physician involvement Manage collection agency relationship: define transfer criteria, monitor recovery performance, and maintain monthly reporting Ensure timely and compliant refund processing and credit management Systems, Workflow & Process Integrity Ensure all RCM operations align with RSM's documented RCM Core Processes and RCM Optimization Plan Proactively investigate technology platforms — Nextech, TriZetto, RetinaOS, IntelliChart Pro (MDI), payer portals, and reporting tools — to identify underutilized functionality, workflow inefficiencies, and optimization opportunities; bring recommendations forward without being asked. Drive reduction of manual processes through automation and workflow redesign through collaboration Own monthly reconciliation process across Nextech, QuickBooks, TriZetto, and bank — ensuring accuracy and alignment with financial close Enforce charge entry, EDI submission, payment posting, denial follow-up, and patient statement timing standards as defined in the RCM Optimization Plan Ensure prior authorization workflows are documented, tracked, and executed — near-zero services without required authorization Maintain standardized documentation practices in Nextech and ensure PCI compliance for credit card processing Strategic Revenue Cycle Insight & Physician Communication Serve as internal expert on payer reimbursement trends, fee schedule performance, and network participation strategy Support evaluation of payer contracts against defined 'strong contract' criteria (rate, administrative burden, timeliness) and provide recommendations for participation adjustments Reinforce analysis of value-based reimbursement performance Provide physician-facing communication on delinquent patient accounts, collection transfers, and A/R summaries — maintaining physician alignment without consuming physician time unnecessarily Stay current on industry trends, payer policy changes, and billing compliance requirements; communicate relevant updates to RSM leadership and staff Support onboarding of new team members through mentoring or training as assigned. Maintain compliance with RSM policies and procedures, including departmental protocols, HIPAA privacy and security standards, and OSHA safety regulations. Actively participate in key performance indicator (KPI), key behavior indicator (KBI), and SMART Goals initiatives aligned with EOS seat expectations. Attend staff and educational meetings as required. Respond to email communications in a timely and professional manner. Perform other duties as assigned. Qualifications and Skills Professional & Interpersonal Skills Display consistent professionalism and a cooperative, team-focused attitude. Demonstrate empathy, energy, and flexibility in interactions with patients and staff. Foster a positive workplace culture in alignment with RSM's core values: Show Respect, Do the Right Thing, Aim for Excellence, Be Curious, Elevate Each Other. Communication & Organizational Skills Possess strong active listening and time management skills. Prioritize tasks effectively while managing multiple responsibilities. Communicate clearly and professionally, including timely email responsiveness. Initiative & Accountability Demonstrate personal ownership of role responsibilities and practice image. Take initiative in accomplishing goals and solving problems. Offer creative, solution-oriented thinking with strong follow-through. Demonstrate the ability to respond to changing demands while maintaining a positive and solution-oriented attitude. Minimum Education/Certification Requirements High school diploma or GED required; Associate's or Bachelor's degree in Healthcare Administration, Business, or related field preferred Must complete departmental certification as outlined by RSM's certification policy. All expenses related to required certification are covered by RSM through its educational funding program. Minimum Background Requirements Minimum 5 years medical billing/RCM experience, with at least 2 years in a supervisory or lead capacity Specialty or Ophthalmology experience preferred; retina or oncology experience strongly preferred Systems Proficiency in Nextech and/or TriZetto strongly preferred; experience with RetinaOS, MDI/IntelliChart, or similar platforms a plus Physical Demands Mobility & Physical Activity Ability to stand and walk for extended periods. Ability to push patients in wheelchairs and assist with mobility needs. Dexterity & Computer Use Ability to view and type computer data efficiently. Ability to communicate effectively via telephone and electronic systems. In accordance with the Americans with Disabilities Act (ADA), reasonable accommodations will be made for qualified individuals to perform essential duties. Employees are responsible for informing management of any accommodation needs.

Job Type:

Full-time Benefits:

401(k) 401(k) matching Dental insurance Health insurance Health savings account Life insurance Paid time off Vision insurance

Education:

Bachelor's (Preferred)

Experience:

Medical billing/

RCM:

5 years (Required)

Supervising:

2 years (Required)

Ophthalmology Practice :

2 years (Preferred)

Work Location:

In person