Revenue Cycle Manager

About the role

The Revenue Cycle Manager is an integral part of our Finance team, responsible for the strategic and operational oversight of revenue cycle activities across multiple healthcare service lines, including primary care, behavioral health, dental, and home health and hospice. This role ensures effective billing operations, payer compliance, revenue optimization, denial reduction, and financial performance through collaboration with internal teams, leadership, external vendors, and clinical departments.

Supervisory Responsibilities

This position oversees three Revenue Cycle Associates and three external vendors.

Responsibilities

• Oversee end-to-end revenue cycle operations, including charge capture, claims submission, payment posting, denial management, accounts receivable follow-up, and reimbursement optimization.
• Identify operational barriers and implement process improvements to improve cash flow and reduce revenue leakage.
• Manage relationships with multiple outsourced revenue cycle vendors, including performance monitoring, workflow coordination, issue resolution, and accountability for deliverables.
• Collaborate with outsourced billing partners to ensure timely claim processing, accurate billing practices, and compliance with payer requirements.
• Evaluate vendor performance and implement process improvements.
• Support workflow optimization, system troubleshooting, and revenue cycle enhancements within various healthcare technology platforms.
• Collaborate with internal teams and vendors regarding system functionality, claim edits, and billing processes.
• Oversee payer portal access, enrollment processes, electronic transactions, and claim submission requirements.
• Maintain knowledge of Medicare, Medicaid, commercial insurance, Medicare Advantage, FQHC reimbursement requirements, and specialty billing regulations.
• Ensure compliance with payer policies, timely filing requirements, billing regulations, and documentation requirements.
• Maintain knowledge of applicable CDT, CPT, HCPCS, ICD-10-CM, Modifiers, and other coding guidelines relevant to the organization’s service lines.
• Support audits, payer inquiries, and revenue cycle compliance initiatives.
• Supervise and support revenue cycle staff, providing guidance, workflow direction, training, and performance support.
• Develop and maintain standard operating procedures, training materials, and workflow documentation.
• Partner with front desk, clinical operations, finance, and leadership teams to improve revenue cycle performance.

Qualifications

• Bachelor’s Degree preferred but not required.
• Five years of experience in a revenue cycle position.
• Coding experience preferred.

Requirements

• Requires prolonged sitting, some bending, stooping, and stretching.
• Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment.
• Requires normal range of hearing and eyesight to record, prepare, and communicate appropriately.
• May require occasional lifting up to 25 pounds.