Revenue Cycle Optimization Manager

About the role

The Revenue Cycle Optimization Manager provides leadership, oversight, and strategic direction for revenue cycle operations across Health Services, ensuring accurate, timely, compliant, and efficient processes throughout the revenue cycle while serving as a subject matter expert and key advisor to leadership.

Responsibilities

• Ensure accurate, timely, compliant, and efficient revenue cycle processes, including patient registration and eligibility, provider and payer enrollment support, charge capture, coding, claim submission, payment posting, denial and appeal management, accounts receivable, patient billing and collections, reimbursement monitoring, and revenue cycle reporting.
• Provide direct leadership and supervision to assigned revenue cycle staff, establishing performance expectations, operational standards, internal controls, and improvement priorities.
• Monitor revenue cycle performance, identify trends and root causes affecting reimbursement, and lead cross‑functional improvement efforts with clinical operations, patient access, providers, Finance, Compliance, Health Information Management, Information Technology, and other Health Services teams.
• Serve as the organizational subject matter expert for revenue cycle business systems and reimbursement workflows, including the electronic health record and applicable payer systems.
• Ensure systems, workflows, fee schedules, payer configurations, and billing processes are maintained and aligned with payer requirements, regulatory standards, contractual obligations, and organizational policies.
• Provide specialized leadership for the unique reimbursement and billing requirements of Federally Qualified Health Centers, CFAA revenue, and other Health Services programs, including oversight of Medicare and Medicaid FQHC reimbursement methodologies, alternative payment arrangements, supplemental payment processes, fee schedules, and implementation of the Health Center Program Sliding Fee Discount Program and billing and collections requirements.
• Exercise a high degree of independent judgment and serve as a key advisor to Health Services leadership on revenue cycle performance, reimbursement strategy, revenue risk, operational improvement, payer trends, and opportunities to maximize appropriate reimbursement for services delivered.