Revenue Cycle Manager

Revenue Cycle Manager Overview

• The Revenue Cycle Manager will oversee billing performance, coding, denials, accounts receivable, and revenue cycle reporting for the client’s integrated clinics.
• Serve as a subject-matter expert and primary liaison to the organization’s outsourced billing partner, ensuring accountability and performance.
• Provide leadership with accurate analysis and actionable recommendations to improve revenue cycle processes and outcomes.
• Maintain compliance with payer requirements, Medicare, Medicaid, commercial insurance, HIPAA, and healthcare billing regulations.
• Utilize advanced analytical skills to investigate and resolve complex reimbursement issues independently.
• Collaborate with internal and external stakeholders to address billing, coding, and credentialing issues effectively.
• Develop and maintain Excel-based reports and dashboards to monitor revenue cycle performance indicators.
• This is a remote position requiring a secure, professional work environment for handling confidential information.

Revenue Cycle Manager Key Responsibilities & Duties

• Coordinate day-to-day revenue cycle issues, escalations, and performance expectations with the outsourced billing company.
• Review and validate billing vendor performance, ensuring accurate and timely completion of contracted activities.
• Analyze denied, rejected, and underpaid claims to identify root causes and implement corrective actions.
• Monitor accounts receivable aging and identify trends, unresolved claims, and workflow issues requiring escalation.
• Prepare concise recurring reports explaining data trends, performance changes, and recommended actions.
• Lead or participate in billing, revenue cycle, credentialing, and payer-related meetings to resolve open issues.
• Support audits, reconciliations, and special projects related to revenue cycle initiatives.
• Collaborate with Finance, Operations, and clinical leadership on billing and reimbursement matters.

Revenue Cycle Manager Job Requirements

• Minimum of 7 years of professional medical billing, coding, or revenue cycle experience required.
• Current Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Biller (CPB) certification required.
• Bachelor’s degree in Health Information Management, Healthcare Administration, or related field preferred.
• Advanced proficiency in Microsoft Excel, including PivotTables, XLOOKUP/VLOOKUP, and data analysis techniques.
• Experience with eClinicalWorks and oversight of outsourced billing vendors strongly preferred.
• Strong knowledge of medical claims processing, coding concepts, and healthcare billing compliance requirements.
• Ability to independently analyze financial data and provide actionable recommendations.
• Strong organizational, attention to detail, and problem-solving skills in a remote work environment.