Manager, Revenue Cycle

Community Health Alliance-Ohio•Fairfield, OH

8d•$75,000 - $90,000•Onsite

About The Position

Community Health Alliance is seeking an experienced, results-driven Revenue Cycle Manager to oversee and optimize revenue cycle operations for its behavioral health organization. The role is responsible for accurate billing, timely reimbursement, effective accounts receivable management, and compliance with Medicaid, Medicare, managed care, and commercial insurance requirements. The manager works collaboratively with clinical, administrative, and finance teams to improve revenue cycle performance, strengthen operational processes, and maximize reimbursement in support of accessible, high-quality behavioral health services. The position leads daily revenue cycle operations and staff, monitors performance metrics, addresses reimbursement barriers, and develops standardized procedures and workflows. It uses CareLogic and other technology systems to improve billing processes, data accuracy, and operational performance. The manager also analyzes trends and prepares reports and recommendations for leadership. Community Health Alliance provides a comprehensive benefits package and describes a collaborative, mission-driven culture, with opportunities for professional growth and career advancement.

Requirements

Bachelor's degree in healthcare administration, business administration, accounting, finance, or a related field; equivalent relevant experience may be considered.
At least 5 years of progressive experience in healthcare revenue cycle management, medical billing, or reimbursement operations.
At least 2 years of supervisory or management experience in a healthcare billing or revenue cycle environment.
Strong working knowledge of Medicaid, Medicare, managed care reimbursement, and commercial insurance billing practices.
Demonstrated experience managing accounts receivable, claim denials, appeals, and revenue cycle performance metrics.
Knowledge of healthcare billing regulations, HIPAA requirements, and applicable payer compliance standards.
Strong analytical, problem-solving, organizational, and communication skills.
Ability to lead teams, implement process improvements, and collaborate effectively across departments.
Proficiency with electronic health records, billing platforms, and Microsoft Excel.

Nice To Haves

Experience in community behavioral health, outpatient mental health, substance use disorder treatment, or integrated healthcare settings.
Experience with CareLogic EHR and billing functionality.
Extensive knowledge of Ohio Medicaid and Medicare Managed Care Organizations and their reimbursement requirements.
Experience with behavioral health service authorization, utilization management, and medical necessity documentation requirements.
Knowledge of provider enrollment, credentialing, and payer contracting processes.
Experience implementing revenue cycle performance dashboards, billing automation, or workflow improvements.
Professional certification such as Certified Revenue Cycle Representative (CRCR), Certified Professional Biller (CPB), or Certified Professional Coder (CPC).

Responsibilities

Oversee daily revenue cycle operations, including billing, claims submission, payment posting, denial management, accounts receivable, and collections.
Ensure accurate, timely, and compliant billing in accordance with Medicaid, Medicare, managed care, and commercial insurance requirements.
Monitor revenue cycle performance indicators, including denial rates, clean claim rates, accounts receivable aging, and collection performance.
Identify reimbursement barriers, revenue leakage, and billing inefficiencies, and implement strategies to improve financial performance.
Manage claim denials, appeals, underpayments, and payer-related issues to maximize reimbursement and minimize payment delays.
Collaborate with clinical leadership and utilization management teams on authorization requirements, medical necessity documentation, and billing-related challenges.
Oversee and support provider enrollment, credentialing, and payer requirements to ensure timely and uninterrupted reimbursement.
Supervise, train, and evaluate billing staff, setting productivity expectations, performance standards, and accountability.
Develop, implement, and maintain standardized billing procedures, internal controls, and workflows to improve efficiency and compliance.
Use CareLogic and other technology systems to optimize billing processes, ensure data accuracy, and improve revenue cycle performance.
Analyze revenue cycle trends and prepare regular financial and operational reports, with recommendations for leadership.
Collaborate with finance, clinical operations, and administrative leadership to support organizational goals, resolve billing challenges, and implement continuous process improvements.