Revenue Cycle Manager

About the role

TCA Health, a Federally Qualified Health Center located on Chicago's far south side, seeks a Revenue Cycle Manager to oversee and optimize the entire revenue cycle process.

Responsibilities

• Billing and collections: Oversee the entire billing process, including charge capture, claims submission, payment posting, and denial management to maximize reimbursement and improve cash flow.
• Ensure compliance with FQHC regulations, including Medicare/Medicaid billing codes, the Prospective Payment System (PPS), and the 340B drug pricing program.
• Monitor and report on key revenue cycle metrics, such as accounts receivable (A/R) days, denial rates, and collection rates, presenting findings.
• Train providers and front-desk staff on documentation and billing practices.
• Manage relationships with insurance companies and government payers, resolve payment disputes, and stay informed about policy changes.
• Identify and implement opportunities to improve efficiency within the revenue cycle through new procedures, software, and automation.
• Oversee the FQHC's sliding fee discount program for uninsured and underinsured patients, ensuring compliance with federal guidelines.
• Manage and optimize the use of electronic health record (EHR) and billing software, such as Epic or eClinicalWorks.

Requirements

• A bachelor's degree in healthcare administration, finance, or a related field is often preferred, but a candidate with significant experience may qualify.
• Typically requires 5+ years of experience in healthcare revenue cycle management.
• Experience working in an FQHC or community health setting is strongly preferred.
• Must have a deep understanding of FQHC-specific billing requirements, reimbursement methodologies (like PPS), and government programs such as Medicaid and Medicare.
• Proficiency with EHR/billing systems, data analytics, and Microsoft Office Suite (especially Excel) is essential.

Qualifications

• Strong analytical, problem-solving, and communication skills are necessary for success in this role.

Skills

• Strong knowledge of FQHC, Medicare, and Medicaid billing regulations.
• Proficiency in EHR systems and data analysis.

Benefits

N/A

Pay

$70,000 - $85,000

Schedule

N/A