Manager of Revenue Cycle Management - FIN051 - Mon-Fri 9AM-5PM

About WellLife Network:

WellLife Network is a leading health and human services organization dedicated to supporting individuals and families across New York City and Long Island. Recognized as a 2023 top-rated nonprofit, WellLife Network empowers people to overcome life’s challenges and achieve greater independence, well-being, and inclusion. We offer a comprehensive suite of programs spanning mental health, developmental disabilities, substance abuse, housing, and employment support, all grounded in a commitment to compassionate, high-quality care. Central to our mission is an unwavering dedication to diversity, equity, inclusion, and belonging (DEIB) within our organization and in the communities we serve. As a trusted community partner, WellLife Network fosters a nurturing environment where everyone has the opportunity to thrive and realize their fullest potential.

Position Summary: The Revenue Cycle Manager is responsible for overseeing all aspects of the revenue cycle, including insurance verification, authorization, billing, collections, and claims management. This role will also support credentialing activities and assist with maintaining and updating the Electronic Health Record (EHR) system. The Manager will collaborate with various departments to resolve discrepancies, ensure compliance with regulatory standards, and optimize revenue cycle performance to meet financial goals.

Essential Accountabilities:

• Manage the full revenue cycle process, including insurance verification, authorization, billing, collections, and denial management.
• Ensure accurate and timely submission of claims to insurance companies and government payers.
• Monitor and manage accounts receivable, collaborating with the billing team to ensure prompt resolution of outstanding claims.
• Investigate and resolve discrepancies and denials, coordinating with insurance providers to ensure proper reimbursement for services rendered.
• Review, analyze, and report on revenue cycle performance metrics to senior leadership.
• Identify revenue cycle challenges and implement solutions to streamline processes and improve overall efficiency.
• Stay current with rules and regulations for OPWDD, OMH, and OASAS billing processes to ensure adherence to industry standards.
• Collaborate with EHR team to maintain and update AVATAR system setup and rate tables, ensuring accuracy in billing and reimbursement.
• Prepare weekly and monthly billing and denial analysis reports for senior leadership.
• Analyze accounts in need of write-offs and recommend appropriate actions.
• Oversee the credentialing and re-credentialing process for all WellLife Network sites and programs with Medicaid, Medicare, MCOs, and Commercial plans.
• Ensure proper setup of accounts with clearinghouses for MCO, Commercial, and Medicare billing to ensure compliance and accurate submissions.
• Participate in regular meetings with the management team and clinic leaders to discuss accounts receivable, revenue maximization, and overall receivables management.
• Work closely with management to set goals for the department (e.g., billing, follow-up, cash posting) and provide guidance to achieve these objectives.
• Manage payroll and attendance for the Revenue Cycle department staff.
• Perform other duties as assigned by management to support the overall success of the Revenue Cycle department.

Qualifications:

• Bachelor’s degree in healthcare administration, business, or related field.
• 3-5 years in revenue cycle management with supervisory experience; experience in credentialing is a plus.
• Strong knowledge of billing, coding, insurance claims, payer policies, and healthcare regulations (HIPPA, ICD-10).
• Proficiency with MS Office, revenue cycle management software, and EHR platforms (e.g., AVATAR, Precision Care).
• Excellent leadership, communication, and problem-solving skills; ability to manage multiple tasks in fast-paces environment.

BENEFITS AND PERKS:

At WellLife Network, we prioritize our employees' growth and well-being with a comprehensive benefits package that includes medical vision, and dental insurance, 401(k) matching, and flexible spending accounts. Enjoy perks like Summer Fridays, gym passes, and life insurance options. Our commitment to career advancement includes tuition assistance, mentorship, leadership training, and more. As a qualifying employer for Public Service Loan Forgiveness, WellLife Network supports your career and financial goals while helping you make a meaningful community impact. Join us to experience a workplace that invests in your success and well-being!