Manager, Revenue Cycle Optimization

Job Title: Revenue Cycle Manager

Position Overview:

The Revenue Cycle Manager will oversee the full revenue cycle, managing both front-end and back-end processes to optimize financial performance. This role requires a detail-oriented professional with a comprehensive understanding of healthcare revenue cycles and strong change management skills to navigate evolving systems and practices. The Revenue Cycle Manager will supervise billing operations, lead denial management efforts, and collaborate with all team members involved in the revenue cycle process to ensure clean and timely billing. This position reports directly to the CFO.

Key Responsibilities:

• Oversee the complete revenue cycle, from patient registration through final payment posting.
• Manage front-end processes, including insurance verification, patient registration, and copay collections.
• Supervise and mentor the billing team to ensure accurate and timely claims submission.
• Collaborate with the Coding Manager to ensure that bills are posted promptly and meet quality standards.
• Train front-end staff on revenue cycle functions and the use of technology and automated tools.
• Develop annual revenue forecasts and prepare pro-forma analyses to support new services and revenue opportunities.
• Conduct fee schedule analyses and recommend revisions based on market assessments.
• Monitor shifts in payer mix and service utilization to ensure compliance with coding protocols and regulations.
• Lead denial management efforts by identifying root causes, implementing corrective actions, and resubmitting claims as necessary.
• Track and report key revenue cycle metrics, such as copay collection rates, denial rates, days in AR, and clean claim rates.
• Ensure compliance with HIPAA and other regulatory requirements related to billing and coding practices.
• Provide comprehensive monthly reports and dashboards, offering actionable insights into revenue cycle performance.

Qualifications:

• Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field (Master’s preferred).
• Minimum of 5 years of progressive experience in healthcare revenue cycle management.
• Expertise in front-end and back-end revenue cycle operations.
• Proven success in denial management and billing supervision.
• Proficient in healthcare billing software, EMR systems, and online insurance portals (e.g., Availity).
• Strong analytical abilities with experience in financial reporting and data-driven decision-making.
• Exceptional leadership and team management skills.
• In-depth knowledge of healthcare regulations and compliance standards, including HIPAA.
• Excellent communication and interpersonal skills.
• Demonstrated ability in change management, leading teams through technological and procedural transitions.

Preferred Skills:

• Proficiency with data analysis tools and revenue cycle KPIs.
• Certification in healthcare revenue cycle management (e.g., HFMA) is a plus.