Revenue Cycle Manager

Responsibilities

• Lead day-to-day operations of the billing department across all clinic locations.
• Manage the entire revenue cycle process including charge entry, claims submission, working denials, A/R follow-up, payment posting, and reconciliation.
• Monitor and manage Athenahealth RCM tools and workflows, including clearinghouse rejections, eligibility, and claim holds.
• Oversee monthly wrap payments, capitation reports, and contractual adjustments.
• Ensure timely and accurate billing in compliance with federal, state, and payer-specific regulations.
• Generate and analyze financial reports and A/R dashboards from Athena.
• Identify trends in denials and reimbursement issues; implement corrective actions.
• Work closely with leadership to support budgeting and forecasting related to patient revenue.
• Train and mentor billing team members, fostering growth and accountability.
• Ensure compliance with RHC/FQHC billing guidelines and payer requirements.
• Serve as the point of contact for audits and payer inquiries.
• Collaborate with clinical and administrative teams to improve coding accuracy and documentation quality.

Qualifications

• Required: Bachelor's degree in Healthcare Administration, Finance, Business, or related field.
• At least 10 years of experience in Revenue Cycle Management, with a focus on RHCs/FQHCs.
• Minimum of 5–10 years of hands-on experience with Athenahealth billing and RCM platform.
• Strong understanding of medical billing, coding, and compliance regulations.
• Demonstrated leadership and supervisory experience.
• Proficiency in analyzing financial data and managing high-volume A/R.
• PREFERRED: Experience with Athena reporting, wrap payments, and Medi-Cal or managed care billing.
• PREFERRED: Familiarity with value-based care models and performance metrics.
• PREFERRED: Knowledge of MACRA, UDS reporting, and ACO participation.
• PREFERRED: Being bilingual in English and Spanish.