REVENUE & BILLING CYCLE MANAGER

Job Summary

The Revenue & Billing Cycle Manager (RBCM) oversees the full billing and collections cycle across ACC Senior Services' multi-service enterprise. This includes primary responsibility for managing skilled nursing facility (SNF) billing, managing billing for senior residential facilities including independent living (IL), assisted living (AL), memory care (MC), and managing the state and private grant billing for ACC’s senior programs.

Essential Job Functions

• Manages the full SNF billing cycle including submission, follow-up, and collections for Medicare, Medi-Cal, Kaiser, and other managed care and commercial payers.
• Ensures accurate and timely claim submission through Point Click Care (PCC) and NetSuite, including UB-04 and other required forms.
• Oversees payer authorization processes, monitors days in accounts receivable, and drives resolution of denied or underpaid claims.
• Maintains up-to-date knowledge of Medicare Part A and Part B billing rules, Medi-Cal reimbursement methodologies, managed care contract terms, and applicable state and federal regulations.
• Serves as primary backup for the SNF Billing Specialist and ensures business continuity during staff absences.
• Reviews and reconciles SNF billing records in coordination with clinical documentation to ensure compliance and revenue integrity.
• Oversees monthly billing for two senior residential facilities (IL & AL) and programs; ensures accuracy across facilities.
• Ensures accurate billing of base rates, ancillary and a la carte services, level-of-care adjustments, and other resident charges in compliance with residency agreements.
• Maintains collections, including aging accounts receivable, payment arrangements, and coordination with family contacts as needed.
• Manages billing for state and private grants supporting ACC’s home and community-based senior programs; ensures compliance with grantor billing requirements, reporting timelines, and allowable cost guidelines.
• Collaborates with ACC’s programs and finance team to reconcile grant expenditures and prepare required documentation for reimbursement.
• Supervises and mentors billing specialists across ACC’s service lines; provides training, quality review, and performance feedback.
• Partners with the Controller and accounting team to ensure billing activity is accurately reflected in NetSuite; supports month-end close reconciliation of accounts receivable.
• Maintains compliance with HIPAA and all applicable state and federal billing regulations.

Qualifications

• Bachelor’s degree in Health Information Management, Accounting, Business Administration preferred or equivalent combination of education and experience.
• Minimum 5 years healthcare billing experience, with significant experience in skilled nursing facility billing required.
• Certified Professional Biller, Certified Medical Reimbursement Specialist, or other relevant billing certification; knowledge of California-specific Medi-Cal billing requirements & long-term care reimbursement rules; healthcare billing certification a plus.
• Experience billing Medi-Cal, Medicare, Kaiser, managed care payers for SNF or long-term care facility; experience with residential billing for assisted living, independent living, or memory care programs.
• Experience with state / private grant billing for senior services / related nonprofit programs.
• Proficiency with PCC / clinical billing software; experience with NetSuite strongly preferred.
• Strong working knowledge of UB-04 billing, payer authorization workflows, denial management, and collections.
• Demonstrated supervisory or team leadership experience; able to explain billing matters clearly to clinical staff, residents, families, and management.
• Excellent written and verbal communication skills; bilingual a plus!
• Proficient in Microsoft Office, including Excel, Word, and Outlook.
• Experience working in a nonprofit senior care, continuing care retirement community or multi-service senior organization preferred.