Revenue Cycle Manager/Front End Biller

Position Summary

The Revenue Cycle Manager/Front-End Biller oversees the front-end revenue cycle process to ensure accurate patient registration, insurance eligibility verification, authorizations, charge entry, claim submission, and reimbursement optimization. This position works closely with clinical staff, utilization review, admissions, business office personnel, and third-party payers to improve cash flow, reduce denials, and maximize reimbursement.

Essential Job Responsibilities

• Oversee front-end revenue cycle operations from patient registration through claim submission.
• Ensure timely and accurate patient registration and demographic information.
• Verify insurance eligibility and benefits prior to services.
• Avoids obtaining required authorizations and referrals.
• Maintain compliance with CMS billing regulations, Medicare and Medicaid billing guidelines, HIPAA Privacy and Security Rules, hospital policies and procedures, and behavioral health reimbursement requirements.
• Monitor key revenue cycle performance indicators.
• Identify opportunities to improve reimbursement and reduce denials.
• Avoids working collaboratively with clinical and business office staff to improve documentation supporting reimbursement.
• Avoids assisting with appeals when necessary.

Financial Reporting

• Monitor daily billing activity.
• Review accounts receivable trends.
• Track reimbursement and denial metrics.
• Prepare revenue cycle reports for leadership.
• Avoids participating in revenue cycle improvement meetings.

Qualifications

• High school diploma or equivalent (Associate's or Bachelor's degree in Business, Healthcare Administration, Accounting, or related field preferred).
• Minimum of three years of healthcare billing or revenue cycle experience.
• Knowledge of hospital billing and reimbursement processes.
• Experience verifying insurance benefits and obtaining authorizations.
• Strong understanding of medical terminology, CPT, HCPCS, and ICD-10 coding principles.
• Excellent communication, organizational, and problem-solving skills.
• Proficiency with Microsoft Office and electronic health record (EHR)/billing systems.

Preferred Experience

• Experience in behavioral health or psychiatric hospital billing.
• Experience with Medicare, Medicaid, Managed Care, and commercial insurance billing.
• Knowledge of outpatient behavioral health and Intensive Outpatient Program (IOP) billing.
• Experience with claims scrubbing, denial management, and reimbursement analysis.
• Familiarity with electronic claim submission platforms and clearinghouses.