Revenue Cycle Manager

Detroit Michigan

100k-175k+

Our client seeking an experienced Revenue Cycle Management (RCM) professional to support our diagnostic laboratory specializing in women’s health, toxicology, and genetic testing. This role focuses on pre-submission, claim scrubbing, and coding accuracy, ensuring every claim isclean, compliant, and optimized for timely reimbursement.

Responsibilities:

● Review and scrub claims prior to submission to ensure all patient, provider,

CPT, and diagnosis information is accurate and complete.

● Validate CPT and ICD-10 codes for accuracy and medical necessity in

accordance with payer and CMS guidelines.

● Identify claim errors, discrepancies, or missing data and coordinate with

internal and external teams (including outsourced billing teams, sales reps,

clinical teams, phlebotomists, and lab IT) to correct and resubmit.

● Maintain up-to-date knowledge of payer-specific policies, modifiers, LCD/NCD

coding rules, and compliance standards for molecular and diagnostic testing.

● Work cross-functionally to ensure claims are optimized for clean submission

and prevent denials or delays.

● Prepare summary reports and performance metrics for stakeholders and

leadership, highlighting recurring issues or process improvements.

● Support internal training and provide feedback loops to ensure ongoing coding

accuracy and RCM process efficiency.

Qualifications:

● 2+ years of experience in RCM, medical billing, or coding (laboratory

experience strongly preferred).

● Strong working knowledge of CPT, ICD-10, and HCPCS coding, particularly

within molecular diagnostics, toxicology, and women’s health.

● Familiarity with claim scrubbing software, EHRs, and clearinghouses.

● Understanding of payer policies, prior authorization workflows, and claim

submission protocols.

● Experience collaborating with multi-departmental teams and external partners.

● Certification such as CPC, COC, or equivalent preferred but not required.

Personal Skills:

● Detail-oriented with strong analytical and problem-solving skills.

● Excellent written and verbal communication.

● Ability to manage multiple priorities and meet tight deadlines.

● Proactive mindset with a passion for accuracy and compliance.

● Self-driven, reliable, and comfortable working both independently and

collaboratively.