Revenue Cycle Manager

Revenue Cycle Manager Overview

• The Revenue Cycle Manager oversees coding, auditing, and billing compliance processes to ensure accurate and timely revenue cycle operations.
• Collaborates with Clinical Operations, IT, and Revenue Cycle teams to optimize workflows and enhance reimbursement strategies.
• Provides leadership to coding and auditing staff, fostering accountability and continuous improvement.
• Ensures compliance with federal/state regulations and payer policies through effective monitoring systems.
• Develops and delivers coding and billing education programs for clinical and non-clinical staff.
• Analyzes denial trends, implements sustainable fixes, and enhances clean-claim rates.
• Monitors KPIs, conducts trend analyses, and presents performance updates to leadership.
• Serves as a subject matter expert on coding, compliance, and revenue cycle best practices.
• Leads continuous improvement initiatives to streamline workflows and improve stakeholder experiences.

Revenue Cycle Manager Key Responsibilities & Duties

• Lead and evaluate coding and auditing staff, setting performance goals and fostering accountability.
• Oversee daily workflows, work queues, and staffing to meet productivity and quality standards.
• Standardize policies and procedures to ensure efficient and compliant operations.
• Conduct internal and external coder audits to maintain high coding accuracy standards.
• Develop and deliver coding and billing education programs for staff and providers.
• Analyze coding denial trends and implement strategies to reduce rework and enhance reimbursement.
• Collaborate with revenue cycle teams to improve claim processing and reduce accounts receivable days.
• Monitor regulatory changes and ensure adherence to Medicare/Medicaid regulations and payer policies.
• Present performance updates and risk analyses to organizational leadership.

Revenue Cycle Manager Job Requirements

• Bachelor of Science in Health Information Management or equivalent required; Master’s degree preferred.
• Minimum of 3 years of experience in revenue cycle management; 5 years preferred.
• CPC Certification required within 1 year of hire; CCS-P Certification within 2 years.
• Proficiency in Microsoft Office Suite, including Teams, Excel, Visio, and PowerPoint.
• Strong analytical, strategic, and process systems thinking skills.
• Demonstrated expertise in coding compliance and revenue cycle best practices.
• Ability to lead and manage teams effectively, fostering collaboration and accountability.
• Excellent communication and interpersonal skills to engage stakeholders and drive objectives.
• Commitment to continuous improvement and adherence to organizational policies and compliance standards.