Senior Revenue Cycle and Claims Project Manager

Pinnacle Method Consulting's mission is to help job seekers reach their career peak by accessing top-tier opportunities. We systematically source and verify roles from premier employers like e4health.

About the role

At e4health, we Empower Better Health. Our team is on a mission to care for those who care for others, bringing passion, ingenuity, and expertise to every engagement. We provide powerful solutions in pursuit of quality, integrity, clinical, and financial value across healthcare. Serving over 400 hospitals and health systems nationwide for nearly two decades, e4health tackles the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise.

This role partners with Finance, Claims, Operations, and IT teams to transform complex data into accurate, meaningful, and user-friendly reports, while also leading strategic projects to improve revenue cycle performance, claims management, and operational efficiency.

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.
• Design, develop, and maintain financial and claims reports that support business operations, regulatory compliance, and strategic decision-making.
• Automate reporting processes while ensuring data integrity.

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) (preferred).
• Project Management Professional (PMP) certification (preferred).
• Athena experience (preferred but not required).