S1.E1: Revenue Cycle Management (RCM): Overview & Job Opportunities.

Think Outside The Box

Revenue cycle management (RCM) is a financial process that manages the revenue generated by a healthcare practice from the services it provides to patients. It streamlines the financial operations of healthcare organizations by identifying, managing and tracking all patient service revenues from registration to final collection, optimizes revenue collection, and minimizes payment delays or denials¹²³⁴. RCM encompasses various activities, including patient registration, insurance verification, charge capture, coding, claims submission, payment posting, and follow-up on outstanding balances. It involves coordinating with patients, healthcare providers, and insurance companies to ensure accurate and timely reimbursement¹⁴. Some of the benefits of RCM are: - Integrating multiple systems to consolidate data and ease multi-departmental revenue collections² - Automating processes such as sending invoices, processing payments, messaging users, performing reconciliations, and putting together reports² - Knowing the quality and accuracy of finances, whether merchant services are currently working well, and how customer interactions are going² - Keeping your organization compliant with the highest security and PCI standards and privacy requirements² Some of the jobs related to RCM are: - RCM Analyst: Responsible for analyzing data and reports related to RCM performance and identifying areas for improvement - RCM Specialist: Responsible for performing various tasks related to RCM such as coding, billing, collecting, and resolving issues - RCM Manager: Responsible for overseeing the RCM team and ensuring that the RCM goals and standards are met - RCM Consultant: Responsible for providing expert advice and guidance on RCM best practices and solutions Source: Conversation with Bing, 17/06/2023 (1) What is Healthcare Revenue Cycle Management (RCM)?. https://www.revenuexl.com/resources/what-is-revenue-cycle-management-rcm. (2) What Is Revenue Cycle Management? | Ultimate Guide | CORE. https://www.corebt.com/blog/revenue-cycle-management-ultimate-guide/. (3) Revenue cycle management - Wikipedia. https://en.wikipedia.org/wiki/Revenue_cycle_management. (4) What is Revenue Cycle Management (RCM)? - Continuum. https://www.carecloud.com/continuum/what-is-revenue-cycle-management-rcm/.