Assistant Manager, Appeals
Commure
Job Level
Mid-LevelSenior
About the role
- Partner with the Director to develop, implement, and refine revenue cycle strategies, processes, and improvement initiatives
- Ensure continuous optimization of billing and collections to maximize revenue
- Coordinate with Revenue Cycle supervisors and managers to streamline claims submission processes
- Perform internal audits of high-value and high-risk claims to identify gaps and drive revenue optimization
- Monitor and review all revenue cycle interfaces, recommend solutions, and support the implementation of process enhancements
- Keep staff and clients updated on billing SOPs, policies, and protocols; ensure policies and procedures are regularly reviewed and communicated
- Establish and enforce KPIs (e.g., A/R over 120 days: <10%, rejection resubmission: <7 business days) and track productivity
- Communicate operational bottlenecks and escalate when needed to prevent delays
- Coordinate with providers on medical necessity-related denials and implement preventive measures; compile and analyze billing error data and develop corrective action plans
- Conduct training sessions on RCM functions, SOPs, and performance standards; provide coaching and professional development
- Prepare audit reports and performance dashboards for leadership; participate in special revenue cycle projects and payer contract reviews as assigned
Requirements
- Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or related field (Master’s preferred)
- 5+ years of progressive experience in healthcare revenue cycle management
- At least 2–3 years in a managerial position
- Proven success in managing RCM
