Manager, Revenue Cycle Operations

Purpose of Position

The Manager of Revenue Cycle will oversee the end-to-end revenue cycle process, ensuring compliance with payer rules and regulations. This role requires expertise in physician, ASC, and hospital billing, payment posting procedures, and denial resolution. The ideal candidate will have a proven track record in managing and training staff to achieve operational excellence and maximize revenue recovery.

Duties and Responsibilities

• Oversee and manage all aspects of the revenue cycle, including billing, claims submission, payment posting, and accounts receivable. Ensure adherence to payer-specific rules, regulations, and reimbursement guidelines for physician, ASC, and hospital billing.
• Staff Management and Training: Recruit, train, mentor, and supervise revenue cycle staff, fostering a culture of continuous improvement and accountability.
• Conduct regular staff evaluations and implement development plans to enhance team performance.
• Denial Management: Analyze and address claim denials, identify root causes, and implement effective resolution strategies. Develop and maintain a robust denial management process to reduce denial rates and improve cash flow.
• Compliance and Reporting: Monitor changes in payer rules and regulations, ensuring compliance across all billing processes.
• Month End Reports: Prepare month end reports for clients. Prepare and present performance reports, including key metrics such as days in A/R, collection rates, and denial trends.
• Process Improvement: Identify opportunities to improve revenue cycle workflows, streamline operations, and enhance overall efficiency.
• Implement best practices and leverage technology to optimize billing and collections processes.

Marginal Functions

• Other duties as needed.

Skills, Knowledge, and Abilities

• Minimum of 5 years of recent experience in revenue cycle management, including physician, ASC, and hospital billing.
• Comprehensive knowledge of payer rules, regulations, and payment posting guidelines.
• Expertise in denial management and resolution, with a proven track record of reducing denial rates and improving reimbursement.
• Experience managing and training revenue cycle staff.
• Proficiency in Excel a must
• Strong analytical, communication, and leadership skills
• Excellent communication and interpersonal skills to serve as a liaison between clients, payers, and providers.
• Problem-solving mindset with the ability to identify and address issues proactively.
• Strong attention to detail and accuracy in data entry and document management.
• Proficient in Microsoft Office Suite (Word, Excel, Outlook).
• Knowledge of credentialing software or healthcare management systems is a plus.
• Strong written and verbal communication skills.
• Ability to work independently and as part of a team.
• Deductive reasoning skill in problem definition, diagnosis, and timely resolution.
• Skilled in maintaining a professional and effective working relationship with other personnel.

Security Roles and Responsibilities

• Implement and act in accordance with the organization's information security policies;
• Protect assets from unauthorized access, disclosure, modification, destruction or interference;
• Execute particular security processes or activities;
• Ensure responsibility is assigned to the individual for actions taken; and
• Report security events or potential events or other security risks to the InfoSec department.

Experience and Education Requirements

• High school diploma; additional computer training or certification will be an asset
• Associate’s degree or higher in business administration, healthcare management, or a related field preferred.
• Minimum of 5 years of recent experience in revenue cycle management, including physician, ASC, and hospital billing
• Experience with the following software a plus: SSI Netbilling, AdvancedMD, Amkai, SFM
• Previous supervisory experience preferred.

A combination of experience and advanced education may be substituted. Background checks and drug test required.

Job Type: Full-time

Pay: From $55,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance

Schedule:

• Monday to Friday

Work Location: In person

Salary : $55,000