Manager of Revenue Cycle

La Rabida Children's HospitalChicago, IL

About The Position

The Revenue Cycle Manager is responsible for the strategic oversight and day-to-day management of the hospital’s financial health. This role leads the Billing and Coding teams in a specialized pediatric environment, ensuring high-quality charge capture, accurate coding, and timely reimbursement. A critical component of this role includes leading the department through a transition from legacy systems (Meditech and Athena) to an Epic platform, while maintaining expert compliance with Illinois Medicaid regulations and pediatric-specific billing requirements.

Requirements

  • Education: Bachelor’s degree in Healthcare Administration, Finance, or a related field (Master’s preferred).
  • Experience: Minimum 5+ years in Healthcare Revenue Cycle Management.
  • Proven experience in a supervisory role overseeing billing and coding professionals.
  • Direct experience with Illinois Medicaid reimbursement and policy.
  • Technical Skills: Proficiency in Meditech and AthenaIDX/One.
  • Change Management: Ability to lead a team through the technical and emotional challenges of a major EHR transition.
  • Analytical Thinking: Deep understanding of healthcare data to identify trends in underpayments or billing errors.
  • Pediatric Focus: Sensitivity to the unique billing needs of a small, 39-bed children’s facility.

Nice To Haves

  • Epic Certification or previous experience leading an Epic Implementation (Resolute Hospital Billing/Professional Billing) is highly preferred.
  • Certifications: CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or CRCR (Certified Revenue Cycle Representative) preferred

Responsibilities

  • Direct Supervision: Manage, mentor, and evaluate the performance of Billing and Coding specialists.
  • Staff Development: Provide continuous training on pediatric-specific coding (ICD-10-CM, CPT, HCPCS) and evolving payer regulations.
  • Workflow Optimization: Establish departmental KPIs (e.g., Days in AR, Clean Claim Rate, Denial Rate) and hold staff accountable to production standards.
  • Legacy Management: Oversee current revenue operations within Meditech (Hospital/Inpatient) and Athena (Ambulatory/Outpatient) to ensure no revenue leakage during the transition.
  • Epic Implementation: Serve as the Revenue Cycle Subject Matter Expert (SME) for the Epic go-live. Duties include workflow design, system testing, data migration validation, and end-user training for the billing/coding modules.
  • Interoperability: Ensure seamless data flow between legacy archives and the new Epic environment.
  • Regulatory Expertise: Serve as the primary resource for Illinois Medicaid (HFS) guidelines, including Managed Care Organizations (MCOs) and the All Kids program.
  • Pediatric Billing: Manage complex pediatric billing scenarios, including neonatal care, rehabilitative therapy, and long-term pediatric chronic care.
  • Audit & Compliance: Conduct internal audits to ensure coding accuracy and compliance with state and federal healthcare laws.
  • Denial Management: Analyze denial trends and implement root-cause solutions to reduce rejections from Illinois Medicaid and commercial payers.
  • Reporting: Prepare monthly financial reports and dashboards for senior leadership regarding AR aging and cash collection targets.
  • Liaison: Act as the bridge between clinical departments and the finance office to ensure clinical documentation supports billed services
© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service