Senior Revenue Cycle and Claims Project Manager

At e4health, we Empower Better Health. The e4health Team is on a relentless mission to care for those teams who care for others. We bring our passion, ingenuity, and expertise to every engagement. Our People make the difference. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. e4health solutions streamline clinical, financial, and health information data and workflows, optimize coding, quality, and clinical documentation integrity processes, and address health IT operational challenges to deliver material results for healthcare organizations across the country.

About the Role

The Senior Revenue Cycle and Claims Project Manager is responsible for leading strategic projects that improve revenue cycle performance, claims management, accounts receivable, reimbursement processes, and operational efficiency across healthcare organizations. This role partners with clinical, financial, IT, compliance, and payer stakeholders to implement process improvements, optimize revenue cycle technology, ensure regulatory compliance, and maximize reimbursement while minimizing claim denials and payment delays.

Responsibilities

• Lead complex revenue cycle and claims management projects from planning through implementation and post-go-live support.
• Develop project plans, timelines, budgets, resource allocations, and risk mitigation strategies.
• Analyze revenue cycle workflows, identify operational gaps, and implement process improvements.
• Collaborate with billing, coding, patient access, HIM, finance, compliance, and IT departments to improve financial performance.
• Monitor key performance indicators (KPIs), including:
  • Clean claim rate
  • Days in Accounts Receivable (A/R)
  • Denial rate
  • First-pass resolution rate
  • Net collection rate
  • Cash collections
• Oversee balancing of A/R for organizations.
• Oversee claims denial management initiatives and root cause analysis.
• Coordinate payer contract implementation and reimbursement optimization projects.
• Support system implementations, upgrades, and integrations involving Electronic Health Records (EHR), Practice Management Systems (PMS), and claims clearinghouses.
• Ensure compliance with CMS regulations, HIPAA requirements, payer policies, and industry standards.
• Facilitate project meetings, provide executive status reports, and communicate project milestones to stakeholders.
• Develop policies, standard operating procedures, and training materials.
• Mentor project team members and provide leadership across cross-functional initiatives.
• Manage vendor relationships and coordinate external consulting resources when necessary.
• Support audits and regulatory reviews related to revenue cycle operations.

Requirements

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Health Information Management, or a related field.
• 7–10+ years of progressive experience in revenue cycle management, claims administration, and accounts receivable balancing and management.
• 5+ years of project management experience leading enterprise-level initiatives.
• Strong knowledge of:
  • Medical billing and coding
  • Claims adjudication
  • Accounts receivable processing and balancing
  • Revenue cycle operations
  • Medicare, Medicaid, and commercial payer regulations
  • Revenue integrity
  • Denial management
• Experience with EHR and practice management systems (e.g., Epic, Cerner, Meditech, Athenahealth).
• Proficiency with Microsoft Office Suite, particularly Excel, PowerPoint, and Project.
• Strong analytical, organizational, communication, and leadership skills.

Qualifications

• Master's degree (MBA, MHA, MPH, or related field).
• Project Management Professional (PMP) certification.
• Athena experience is preferred but not required.
• Certified Revenue Cycle Representative (CRCR).
• Certified Healthcare Financial Professional (CHFP).
• Lean Six Sigma Green Belt or Black Belt certification.
• Experience with healthcare analytics and business intelligence tools (e.g., Tableau, Power BI).

Benefits

• 401(k) with company match (eligibility after 90 days for full-time employees or 250 hours for part-time employees).
• Full benefits package including medical, dental, vision, life, and short/long term disability insurance.
• Paid time off (PTO) policy.

Physical Demands

• Sitting, talking, hearing, and near vision required over 90% of the time.
• Feeling required over 90% of the time; reaching required about 50% of the time.
• Ability to travel to field sites may be required up to 15% of the time.

Working Conditions

• Over 90% of the time is spent indoors, with protection from weather conditions.
• Exposure to noise levels that may be distracting or uncomfortable is present in only unusual situations.