Revenue Cycle Manager
Position Summary
The Revenue Cycle Manager is responsible for overseeing the complete revenue cycle—from patient registration and insurance verification through billing, collections, payment posting, denials management, and reimbursement. This leader will work closely with clinical, operational, and finance teams to maximize revenue, improve cash flow, and ensure compliance with healthcare regulations.
Key Responsibilities
Manage all aspects of the revenue cycle, including:
- Patient registration and insurance verification
- Benefits eligibility
- Prior authorizations
- Medical coding coordination
- Charge capture
- Claims submission
- Payment posting
- Accounts receivable
- Collections
- Denials management
- Appeals and reimbursement
Monitor key performance indicators (KPIs) to improve cash collections, reduce denials, and accelerate reimbursement.
Ensure timely and accurate claim submission and payment reconciliation.
Healthcare Billing Expertise
Maintain expert knowledge of:
- Commercial insurance billing
- Medicare and Medicaid reimbursement
- Patient co-pays, deductibles, and coinsurance
- Skilled Nursing Facility (SNF) billing
- Wound care billing and documentation requirements
- Medical necessity and payer compliance
Operational Excellence
Review, develop, and improve revenue cycle policies, procedures, and workflows.
Identify process gaps and implement scalable solutions that improve efficiency, compliance, and financial performance.
Create programs that improve operational consistency, billing accuracy, and overall business practices.
Lead continuous improvement initiatives across all revenue cycle functions.
Startup & Growth Support
Assist in launching and integrating new practice locations and service lines.
Develop standardized revenue cycle processes for startup operations.
Build scalable workflows that support organizational growth.
Collaborate with leadership to implement best practices across expanding operations.
Team & Vendor Management
Supervise revenue cycle staff and provide coaching, training, and performance management.
Partner with physicians, clinical leadership, finance, and operations to resolve billing issues and improve workflow.
Manage relationships with billing vendors, clearinghouses, insurance carriers, and third-party service providers.
Collaborate with global support teams to ensure consistent execution and communication across the organization.
Compliance & Reporting
Ensure compliance with HIPAA, CMS regulations, payer requirements, and internal policies.
Prepare and present revenue cycle performance reports to executive leadership.
Analyze trends and develop action plans to improve financial outcomes.
Qualifications
Bachelor's degree in healthcare administration, Business Administration, Finance, Accounting, or a related field (or equivalent experience).
5+ years of progressive experience in healthcare revenue cycle management.
Strong knowledge of:
- Medical billing and collections
- Revenue cycle operations
- Insurance reimbursement
- Patient co-pays and deductibles
- Skilled Nursing Facility (SNF) billing
- Wound care billing and documentation requirements
- Medical necessity and payer compliance
Experience working within physician practices, outpatient healthcare organizations, or multi-site healthcare environments.
Experience implementing and improving operational policies and procedures.
Strong analytical, organizational, and leadership skills.
Proficiency with electronic medical records (EMR/EHR), practice management systems, and Microsoft Office, particularly Excel.
Preferred Experience
Supporting startup healthcare organizations or rapidly growing medical practices.
Certification such as Certified Revenue Cycle Representative (CRCR), Certified Professional Biller (CPB), Certified Professional Coder (CPC), or equivalent.
Experience managing remote or global support teams.
Knowledge of wound care, post-acute care, mobile healthcare, or skilled nursing operations.