Revenue Cycle Manager

JOSEPH P. ADDABBO FAMILY HEALTH CENTER, INC.•New York, NY

About The Position

Under the direction of the Vice President of Revenue Cycle and Health Information Management, the Revenue Cycle Manager oversees all revenue cycle functions for the Joseph P. Addabbo Family Health Center, a Federally Qualified Health Center (FQHC). The Manager ensures accurate, compliant, and timely billing, coding, collections, and reimbursement across medical, pediatric, dental, behavioral health, specialty, and enabling services. This role provides direct and indirect oversight of front end, mid cycle, and back end operations and partners closely with clinical, operational, and finance leadership to optimize revenue integrity, reduce denials, and support the financial sustainability of the organization. Responsibilities include developing and implementing policies, leading and supporting staff and vendor partners, and maintaining electronic and paper based systems in accordance with organizational policies and all applicable federal and state regulations, including HRSA, CMS, Medicaid, Medicare, and UDS reporting requirements. The Revenue Cycle Manager also ensures compliance with HIPAA and internal privacy/security standards and stays current on FQHC specific billing rules, PPS rate changes, and managed care contract requirements. This is a key leadership role that requires strategic thinking, operational excellence, and strong collaboration across the health center and the community we serve.

Requirements

Experience in revenue cycle management, particularly within a Federally Qualified Health Center (FQHC) setting.
Knowledge of medical, pediatric, dental, behavioral health, specialty, and enabling services billing.
Understanding of front-end, mid-cycle, and back-end revenue cycle operations.
Familiarity with HRSA, CMS, Medicaid, Medicare, and UDS reporting requirements.
Knowledge of HIPAA and internal privacy/security standards.
Awareness of FQHC-specific billing rules, PPS rate changes, and managed care contract requirements.
Strategic thinking and operational excellence.
Strong collaboration skills.

Responsibilities

Direct, supervise, and develop staff across registration, eligibility, coding, billing, and collections; this will entail strategic collaboration with Clinical Operations division and clinical leadership, and the direct oversight of revenue cycle vendor related services.
Establish and enforce clear performance metrics and accountability standards for the revenue cycle team and/or revenue cycle vendor services.
Provide ongoing training on FQHC billing rules, payer updates, and compliance requirements.
Ensure accurate patient registration, insurance verification, sliding fee scale application, and collection of patient responsibility.
Collaborate with internal stakeholders to improve and maintain workflows for prior authorizations, referrals, and financial counseling.
Collaborate with clinic managers to reduce registration errors and improve point of service collections.
Partner with clinical leadership to improve documentation quality and reduce coding-related denials.
Monitor coding denials and communicate trends to leadership and resource(s) leading coding initiatives with the clinical providers.
Collaborate with and contribute to routine audits of provider documentation and coding.
Oversee claims submission, payment posting, denial management, and accounts receivable follow up; this will include management of the related revenue cycle vendor services.
Maintain timely and accurate billing for Medicaid, Medicare, commercial plans, self-pay, and grant funded services.
Monitor AR aging and implement strategies to reduce outstanding balances and write-offs.
Ensure adherence to federal and state regulations, including HRSA, CMS, Medicaid, Medicare, and UDS reporting requirements.
Maintain compliance with HIPAA and internal privacy/security policies.
Stay current on FQHC-specific billing rules, PPS rate changes, and managed care contract requirements.
Develops, updates, recommends, and implements Revenue Cycle policies and procedures in accordance with respective regulatory requirements.
Produce regular reports on AR, denials, cash collections, payer trends, and productivity.
Analyze data to identify revenue leakage, operational bottlenecks, and opportunities for improvement.
Support annual audits, cost reports, and UDS submissions.
Work closely with Finance to support budgeting, forecasting, and month-end closure.
Partner with Operations and Clinical teams to align workflows and improve patient access and throughput.
Collaborate with IT/EHR teams to optimize system configuration, templates, and revenue cycle tools.
Other duties assigned.