Manager_Transition

About the Role We are seeking an experienced RCM Manager to lead our Professional (CMS-1500) Billing operations across multiple specialties. This role owns end-to-end billing delivery for existing client accounts, drives new client/project implementations, and oversees EDI and ERA enrollment functions. The ideal candidate combines strong operational management skills with deep subject-matter expertise in US healthcare provider billing, and has a track record of leading teams through client transitions and go-lives.   Key Responsibilities Operations & Team Management Manage day-to-day operations of the professional billing team across multiple specialties and client accounts Set, monitor, and drive team performance against KPIs: clean claim rate, days in AR, denial rate, productivity, and quality/accuracy targets Conduct regular huddles, one-on-ones, and performance reviews; manage coaching, training, and PIPs as needed Own workforce planning, shift scheduling, and capacity/utilization management Build and maintain SOPs, training materials, and quality audit frameworks for the billing function Escalation point for complex claims, payer issues, and client escalations New Project / Client Implementation Lead billing workstreams for new client onboarding and transitions, from kickoff through go-live and stabilization Partner with Implementation, Credentialing, IT, and Coding teams to define timelines, dependencies, and readiness criteria Oversee PM/EHR system configuration validation, charge master setup, and fee schedule mapping relevant to billing Drive parallel billing runs, UAT, and go/no-go decisions for new accounts Identify workflow gaps and implement process improvements during and after transition Present implementation status, risks, and readiness updates to internal leadership and client stakeholders EDI & ERA Enrollment Oversight Own the EDI enrollment function across payers and clearinghouses, ensuring timely completion and tracking Oversee ERA (835) / EFT enrollment processes, ensuring accurate payer setup for electronic payment posting Manage relationships and escalations with clearinghouse partners (e.g., Availity, Waystar, Change Healthcare, Office Ally, Trizetto) Review and approve enrollment trackers; ensure SLAs for enrollment turnaround are met Troubleshoot systemic EDI/ERA issues impacting claim transmission or payment posting across accounts Reporting & Stakeholder Management Prepare and present operational dashboards and MBRs/QBRs to internal leadership and clients Analyze denial trends, AR aging, and root causes; drive corrective action plans Ensure compliance with HIPAA, payer regulations, and internal quality standards Act as primary liaison between the billing team, client stakeholders, and internal support functions (Credentialing, Coding, IT, AR/Denials)   Required Qualifications [8+] years of experience in US Healthcare Professional (Physician) Billing / RCM, with at least 3+ years in a supervis...