Manager of Reimbursement

OrthoArkansas•North Little Rock, AR

13d

About The Position

The Reimbursement Manager at OrthoArkansas is responsible for the daily operational leadership of the Revenue Cycle department, providing direct oversight to five functional supervisors and indirect leadership to approximately 64 team members. This role serves as the operational bridge between departmental strategy and front-line execution, ensuring consistent performance across all billing, collections, coding, pre-certification, and financial counseling functions. The Reimbursement Manager partners closely with the Director of Reimbursement and Senior Leadership to drive accountability, improve operational efficiency, optimize reimbursement outcomes, and support organizational growth.

Requirements

Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field preferred.
Minimum of 5 years of Revenue Cycle experience required.
Minimum of 2 years of supervisory or management experience overseeing teams of 10 or more employees.
Experience with professional and ancillary billing in a multi-specialty healthcare environment preferred.
Experience supporting surgical and imaging authorization processes preferred.
Strong knowledge of revenue cycle operations, denial management, insurance follow-up, and self-pay collections.
Working knowledge of ICD-10, CPT, HCPCS coding concepts, and payer reimbursement methodologies.
Proven leadership skills with the ability to develop supervisors, manage performance, and drive accountability.
Excellent analytical, problem-solving, and decision-making abilities.
Strong communication and interpersonal skills with the ability to collaborate effectively across departments.
Ability to manage multiple priorities and thrive in a fast-paced, high-volume healthcare environment.
Strong understanding of regulatory compliance, payer requirements, and revenue cycle best practices.
Advanced: Revenue Cycle Management Systems, Spreadsheet Applications, Reporting Tools, Word Processing.
Intermediate: Electronic Health Records (EHR), Practice Management Systems, Presentation Software, Database Management.

Nice To Haves

Certified Revenue Cycle Specialist (CRCS).
Certified Professional Coder (CPC).
Other applicable Revenue Cycle or healthcare management certifications.
Preferred Experience: AI-assisted Revenue Cycle tools, denial analytics platforms, automation software, and payer portals.

Responsibilities

Oversee daily operations across Ancillary Billing, Financial Counseling/Self-Pay, Coding, Pre-Certification, and Insurance Collections.
Monitor departmental performance metrics including work queue aging, denial rates, authorization turnaround times, clean claim rates, self-pay collections, and productivity benchmarks.
Conduct regular operational meetings and supervisor check-ins to identify barriers and improve workflow efficiency.
Ensure consistent billing and reimbursement operations across all clinic locations, surgery centers, imaging services, and billing providers.
Serve as the first point of escalation for operational issues, complex claim disputes, and patient billing concerns requiring management intervention.
Coach, mentor, and develop supervisors to build strong leadership capabilities and accountability.
Partner with supervisors to address employee performance concerns in accordance with company policies and HR guidelines.
Lead cross-training initiatives to maintain operational continuity during employee absences, leaves of absence, and staffing transitions.
Identify high-potential employees and develop succession plans for future leadership opportunities.
Support recruitment, onboarding, and training efforts for Revenue Cycle team members.
Oversee denial management processes and ensure timely submission of appeals.
Monitor denial trends by payer, denial category, and service line to identify opportunities for improvement.
Collaborate with Coding, Clinical, and Provider teams to address documentation deficiencies impacting reimbursement.
Monitor self-pay accounts receivable, financial assistance programs, and collection performance.
Escalate systemic payer issues, audit findings, and reimbursement risks to leadership with supporting data and recommendations.
Champion adoption of technology solutions including automation tools, AI-assisted prior authorization platforms, denial analytics software, and coding support systems.
Develop, maintain, and standardize departmental workflows, policies, procedures, and training materials.
Identify operational inefficiencies and lead process improvement initiatives with measurable outcomes.
Participate in testing, implementation, and staff training for EHR and practice management system enhancements impacting revenue cycle operations.
Present recommendations and improvement strategies to leadership based on operational performance data.
Ensure departmental compliance with CMS regulations, HIPAA requirements, payer guidelines, and organizational policies.
Prepare and present operational dashboards, reports, and performance metrics to executive leadership.
Monitor key performance indicators and proactively identify early warning signs of operational or financial performance concerns.
Support internal and external audits by coordinating documentation, staff responses, and corrective action plans.
Perform other related duties as assigned to support departmental and organizational objectives.