Revenue Cycle Manager - Healthcare

WACBD - Washington Center for Bleeding Disorders • Seattle, WA

9h

About The Position

We are seeking a strategic and collaborative Revenue Cycle Manager to lead all revenue cycle operations for our Hemophilia Treatment Center and integrated Specialty Pharmacy. In this high-impact role, you will optimize financial performance while championing patient access to life-changing therapies. You will drive efficient, compliant, and patient-centered processes that support our mission and ensure organizational sustainability in a complex reimbursement landscape.

Requirements

• Bachelor’s degree in business, healthcare administration, finance, or related field; equivalent experience considered.
• 5+ years of revenue cycle experience in healthcare, with at least 2 years in a supervisory or management role.
• Strong understanding of specialty pharmacy billing, high‑cost medication reimbursement, and payer authorization processes.
• Knowledge of outpatient medical billing, including coding standards (ICD-10, CPT, HCPCS) and reimbursement methodologies.
• Experience managing claims for commercial plans, Medicaid, Medicare, and specialty pharmacy benefit programs.
• Proficiency with electronic health records (EHRs), pharmacy management systems, and billing platforms. Experience with NextGen EHR, NewLeaf, and R2 billing platform highly preferred.
• Strong problem-solving skills, analytical mindset, and attention to detail.

Nice To Haves

• Experience working in a hemophilia treatment center (HTC), specialty pharmacy, or chronic disease management program.
• Familiarity with 340B regulations (if applicable to WACBD).
• Certification such as CRCR, CPC, CPB, or CHFP.

Responsibilities

• Oversee the full revenue cycle, including patient registration, insurance verification, prior authorization, coding, billing, collections, and payment posting.
• Lead proactive initiatives to ensure continuous and optimal insurance coverage across the patient population, minimizing gaps that could interrupt access to life-saving therapies.
• Collaborate with clinical, pharmacy, and patient services teams on regular eligibility verification, insurance re-assessments, plan transitions, appeals, and enrollment in manufacturer assistance programs, foundation support, and other financial resources.
• Analyze population-level coverage trends, payer mix, and at-risk patients to develop targeted interventions that improve overall reimbursement and reduce financial barriers to care.
• Champion patient-centered financial navigation, providing guidance on benefits, cost-sharing responsibilities, and coverage retention strategies to support long-term treatment adherence and health outcomes.
• Develop, implement, and maintain revenue cycle policies, workflows, and compliance standards aligned with federal and state regulations.
• Develop and monitor key performance indicators (KPIs) such as days in A/R, denial rates, clean claim rates, reimbursement trends, and pharmacy-specific revenue metrics.
• Direct billing workflows for factor and specialty medications, including high-cost therapies and 340B program considerations.
• Ensure compliance with specialty pharmacy billing rules, clinical documentation requirements, and payer contract terms.
• Support accurate documentation and audit readiness for payer reviews and compliance programs.
• Prepare regular revenue cycle reports for leadership, identifying trends, risks, and opportunities for improvement.
• Proactively analyze payer reimbursement patterns, provide comprehensive data and strategic recommendations and support contract negotiations with payers and pharmacy benefit managers
• Forecast revenue impacts based on regulatory changes, payer policy updates, and internal operational shifts.
• Supervise and mentor the revenue cycle team, including billing specialists, authorization staff, and support personnel.
• Foster strong cross-department communication with pharmacy, clinical, finance, and administrative teams.
• Lead training initiatives on billing compliance, documentation requirements, and payer updates.
• Champion continuous process improvement initiatives within the revenue cycle to enhance efficiency, reduce costs, and maximize clean claim rates and collections.
• Ensure revenue cycle processes are patient-centric, minimizing financial barriers and providing clear communication to patients regarding their financial responsibilities and options.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1-10 employees