Overview
This role involves managing the entire revenue cycle process to ensure accurate and timely billing, collections, and reimbursement. The Revenue Cycle Manager will lead daily operations, enhance compliance, and utilize performance metrics to improve cash flow and the patient financial experience.
Responsibilities
- Manage the full revenue cycle process, including pre-registration, billing, collections, and accounts receivable.
- Develop, implement, and maintain policies and procedures to improve revenue cycle efficiency, accuracy, and internal controls.
- Monitor key performance indicators (KPIs) and analyze trends to identify risks, root causes, and opportunities for improvement.
- Collaborate with clinical and administrative teams to support accurate documentation and coding aligned with payer and regulatory requirements.
- Coordinate with payers to resolve claim issues, denials, and payment variances to support timely reimbursement.
- Lead, coach, and develop the revenue cycle team through training, performance management, and ongoing process support.
- Conduct periodic audits of billing and accounts receivable to ensure compliance with organizational policies and applicable regulations.
- Prepare and present revenue cycle performance reports and recommendations to leadership.
- Stay current on healthcare regulations, payer rules, and industry best practices to maintain compliance and optimize reimbursement.
Requirements
- Bachelor’s degree in business, healthcare administration, finance, or a related field (or equivalent experience).
- Minimum of 3 years of progressive revenue cycle management experience in a healthcare setting, including billing, coding, and collections.
- Working knowledge of healthcare regulations, payer contracts, and reimbursement methodologies.
- Strong analytical and problem-solving skills with the ability to interpret performance and financial data to drive decisions.
- Demonstrated leadership capabilities with a track record of building collaborative, high-performing teams.
- Proficiency with revenue cycle management systems and electronic health records (EHRs).
- Excellent written and verbal communication skills, capable of working effectively with diverse stakeholders.
Preferred Qualifications
- Experience with Athena or comparable practice management/EHR platforms.