Revenue Cycle Manager

CHD Careers•Springfield, MA

About The Position

The Revenue Cycle Manager oversees and optimizes CHD’s end-to-end revenue cycle across behavioral health, primary care, CBHC, CBHI, SUD, residential, and community-based service lines. Reporting to the Sr. Director of Revenue Cycle Management, this role leads billing, coding, accounts receivable, denial management, and authorization staff to support accurate billing, timely reimbursement, and full revenue capture. The manager partners with Clinical Operations, Finance, IT, Compliance, and Program Leadership to strengthen cash flow, reduce preventable denials and write-offs, and support CHD’s long-term financial sustainability. The role also develops team standards and performance measures, analyzes revenue cycle data, and coordinates improvements across programs and departments.

Requirements

Bachelor’s degree in Healthcare Administration, Business Administration, Accounting, Finance, or a related field.
At least 5 years of progressive healthcare revenue cycle experience.
At least 3 years in a managerial or supervisory capacity.
Deep familiarity with MassHealth, Medicare, commercial insurance, managed care, authorizations, and denial workflows.
Proficiency with EHR or practice management systems, clearinghouses, and claim-editing tools.
Advanced Excel skills.
Ability to build and interpret revenue cycle data and reporting to support operational improvements.
Ability to establish performance metrics, coach staff, and collaborate across clinical operations, credentialing, IT, and finance.

Nice To Haves

Master’s degree.
Experience in behavioral health, community health, or non-profit healthcare.
Experience with reporting tools such as Power BI.
CRCR, CPB, CPC, CHAA, or comparable HFMA revenue cycle credentials.

Responsibilities

Oversee end-to-end revenue cycle workflows, including eligibility verification, authorization, charge capture, coding, claim submission, payment posting, and collections.
Establish team performance and turnaround standards.
Ensure accurate and timely claim submission to MassHealth, Medicare, Medicaid managed care plans, and commercial payers.
Set and track targets for clean claim rates, days in accounts receivable, and net collection rates.
Maintain a formal denial prevention process; analyze root causes across programs and providers, oversee appeals and reconsiderations, and coordinate corrective actions with operational and IT teams.
Collaborate with credentialing staff to prevent revenue loss caused by enrollment delays.
Ensure billing practices comply with CMS, MassHealth, commercial payer rules, and HIPAA regulations.
Build and maintain executive revenue cycle dashboards and translate data into actionable recommendations to optimize reimbursement across service lines.
Supervise, train, and evaluate assigned billing, coding, accounts receivable, and authorization staff.
Promote accountability, continuous improvement, and cross-departmental collaboration.