Recruiter's Glossary

Examples: Medical Staff Services • Value-Based Care • Remote Patient Monitoring

Revenue Cycle Management

Term from Medical Practice industry explained for recruiters

Revenue Cycle Management (RCM) is the financial process used in medical practices and healthcare facilities to track patient care from registration and appointment scheduling to the final payment of a balance. Think of it as the complete journey of managing all the billing and payments in a healthcare setting. It starts when a patient makes an appointment and continues through collecting their insurance information, billing them correctly, and making sure the practice gets paid. This process helps medical practices and hospitals maintain a healthy cash flow and reduce billing errors. It's similar to an accounts receivable process but specifically designed for healthcare with its unique insurance and compliance requirements.

Examples in Resumes

Managed Revenue Cycle Management team of 10 staff members, reducing payment collection time by 30%

Implemented new RCM software system, improving clean claims rate to 95%

Led Revenue Cycle optimization project resulting in $2M additional annual revenue

Supervised daily Revenue Cycle Management operations for multi-specialty medical practice

Typical job title: "Revenue Cycle Managers"

Also try searching for:

Revenue Cycle Director Medical Billing Manager Patient Financial Services Manager Healthcare Revenue Specialist RCM Manager Practice Management Director Medical Collections Manager

Where to Find Revenue Cycle Managers

Professional Associations

Online Communities

Job Boards

Example Interview Questions

Senior Level Questions

Q: How would you improve a healthcare facility's collection rate?

Expected Answer: A senior manager should discuss strategies like implementing pre-registration verification, improving front-end collections, training staff on insurance verification, utilizing analytics for identifying payment trends, and implementing patient-friendly payment plans.

Q: How do you handle denied claims and prevent future denials?

Expected Answer: Should explain the process of analyzing denial patterns, implementing preventive measures, training staff on proper documentation, and maintaining relationships with insurance companies to resolve issues quickly.

Mid Level Questions

Q: What key performance indicators (KPIs) do you track in revenue cycle management?

Expected Answer: Should mention metrics like days in accounts receivable, clean claims rate, collection rate, denial rate, and point-of-service collections, explaining why each is important.

Q: How do you ensure compliance with insurance and Medicare regulations?

Expected Answer: Should discuss staying updated with regulatory changes, maintaining proper documentation, regular staff training, and implementing compliance checks in the billing process.

Junior Level Questions

Q: What is the basic revenue cycle process from patient registration to payment?

Expected Answer: Should be able to describe the basic steps: patient scheduling, registration, insurance verification, service delivery, coding, billing, payment posting, and follow-up.

Q: What is the difference between copayment, coinsurance, and deductible?

Expected Answer: Should explain these basic insurance terms and how they affect patient billing and collections.