Revenue Cycle Manager
About The Position
The Revenue Cycle Manager manages and oversees the organization’s authorization, coding, billing, claims, and collections. The role is responsible for maximizing departmental productivity and minimizing errors through structured auditing, reporting, and follow-up training. It also has a strategic and practical role within the finance department, including day-to-day responsibility for billing processing and strategy, planning, management and analysis, and policy development. The position oversees the authorization, invoicing, and collections functions; manages denials and related reporting, accountability, and resolution; and helps ensure confidentiality and compliance with federal guidelines, established policies and processes, and payer and provider contracts. The manager develops and implements procedures and productivity and quality metrics, trains and coaches team members, and communicates revenue cycle results and trends to the executive team. The role collaborates with Finance on month-end close and annual audits and may perform other duties assigned by management.
Requirements
- Bachelor’s degree in Business, Finance, Accounting, Healthcare Administration, or equivalent.
- At least 5 years of billing experience.
- At least 3 years of management experience, including managing subordinates and teams.
- Experience working in an integrated health care system.
- Experience with accounts receivable, daily and monthly closings, and the revenue cycle for all payers.
- Demonstrated knowledge of insurance companies, HMOs, PPOs, Medicare, and third-party payers.
- Experience directly overseeing payer and provider billing, collections, and cash posting.
- Ability to facilitate communication among stakeholders, extract relevant information, identify problems, and develop sustainable, scalable solutions.
- Ability to optimize the revenue cycle through team members, operational processes, and detailed data analysis.
- Understanding of key metrics, revenue drivers, and ROI expense analytics.
- Strong research and auditing skills, with the ability to analyze financial information and determine its business impact.
- Ability to identify and resolve issues in a timely and proactive manner.
- Ability to communicate a vision, align and develop team members, recognize success, provide direct feedback and coaching, delegate appropriately, and hold team members accountable.
- Ability to build trusting, mutually respectful relationships with professionals and clinicians.
- Strategic planning skills, including setting monthly, quarterly, and annual objectives; measuring and communicating monthly results; and planning 6–12 months ahead.
- Ability to collaborate with peers and support resources and to innovate and analyze operational improvements.
- Detail-oriented, organized, process-focused, proactive, self-motivated, and customer-service-focused approach.
- Independent judgment and ability to make timely, accurate decisions using information that may be vague or limited.
- Ability to multitask and prioritize tasks and projects with limited direction in a fast-paced, sometimes ambiguous environment without compromising work quality.
- Ability to contribute to organizational success.
Nice To Haves
- Master’s degree in Business, Finance, Accounting, or Healthcare Administration.
- Considerable prior coursework or on-the-job training in ophthalmology, insurance, and management.
- Knowledge of Word, Excel, PowerPoint, and CareCloud.
- Revenue Cycle Certification; desired but not required.
Responsibilities
- Manage the organization’s full revenue cycle.
- Oversee the day-to-day activities of the authorization, invoicing, and collections department.
- Oversee denials management, including reporting, accountability, and resolution.
- Protect confidentiality in accordance with federal guidelines and established policies and processes, and ensure compliance with payer and provider contracts.
- Lead the development and implementation of policies and procedures to ensure compliance with new regulatory standards affecting billing and revenue.
- Manage, train, and coach team members; create personnel development and succession plans; and partner with HR as needed to maintain an engaged and productive team.
- Summarize and communicate revenue cycle successes, challenges, and trends to the executive team.
- Create and implement productivity and quality metrics.
- Create, develop, and implement standard operating procedures and streamline processes.
- Collaborate with the Finance team on month-end close and annual audit processes.
- Perform other duties as assigned by management.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
