Revenue Cycle Manager

University of the Pacific•Stockton, CA

21h

About The Position

Under the general supervision of the Director of Patient Financial & Revenue Cycle, the Revenue Cycle Manager is responsible for the overall management and performance of the Clinic’s patient revenue cycle. The role ensures timely and accurate reimbursement from Medicare, Medi-Cal, commercial insurance, managed care, and private payers, and oversees billing office operations from pre-claim review through final payment resolution. Areas of oversight include coding, claims submission, accounts receivable, denial management, collections, credentialing, compliance, and reporting. The Revenue Cycle Manager develops policies, monitors key performance indicators, ensures regulatory compliance, improves operational efficiency, and leads the billing team to maximize cash collections while maintaining strong organization and compliance. The position also works with vendors and insurance representatives, oversees billing audits and documentation reviews, and recommends improvements to executive leadership. The University of the Pacific recognizes diversity, equity, and inclusion as foundational to the success of its students and employees. It prioritizes policies and decisions that demonstrate awareness of and responsiveness to the ways sociocultural forces related to race, gender, ability, sexuality, and socioeconomic status can impede or propel students, faculty, and staff.

Requirements

Knowledge of insurance billing, appeals, collections, and contractual adjustments.
Knowledge of dental and medical insurance credentialing.
Ability to manage time effectively, balance multiple priorities, and complete tasks and projects successfully.
Proven ability to navigate complex and urgent issues with clarity and efficiency.
Knowledge of dental terminology, treatment, and insurance procedures.
Knowledge of electronic dental billing systems and accounting and billing procedures.
Knowledge of management and supervision principles.
Proficiency with Microsoft Excel, Word, and Access.
Ability to communicate effectively with a diverse population of patients, students, staff, faculty, and administration.
Ability to produce professional, concise reports and written correspondence.
Ability to analyze financial reports and KPIs and make appropriate recommendations.
Ability to meet benchmarks in a fast-paced, high-volume setting and work independently with minimal supervision.
Ability to provide effective leadership, training, and supervision.
Ability to maintain confidentiality and exercise professional judgment.
Ability to manage multiple projects and consistently meet deadlines.
Minimum 3–5 years of dental insurance claims processing experience.
Minimum 3 years of increasingly responsible management experience, preferably in a dental or medical office.
Minimum 3 years of revenue cycle management experience.
Bachelor’s degree in a related field or 4 years of relevant experience.

Nice To Haves

Experience in dental group practice or dental school is highly desirable.
Bilingual skills are helpful.
Experience and sensitivity in working with people of diverse backgrounds and cultures.
Ability to engage and integrate culturally responsive practices and knowledge in work.

Responsibilities

Direct and oversee all aspects of clinic revenue cycle management to ensure efficient and compliant billing operations.
Manage the claims lifecycle, including charge entry, claims submission, payment posting, denial management, and account resolution.
Ensure accurate and timely billing and reimbursement for Medicare, Medi-Cal, commercial insurance, managed care, and self-pay accounts.
Monitor billing accuracy, clean claim rates, and revenue cycle performance metrics.
Develop, implement, and optimize revenue cycle workflows, processes, and improvement initiatives to improve revenue capture, billing accuracy, collections, reimbursement speed, workflow efficiency, automation, customer satisfaction, and financial outcomes, while reducing claim turnaround times.
Oversee timely follow-up on unpaid claims to maximize collections and reduce accounts receivable aging.
Monitor accounts receivable aging and collection performance; establish collection priorities and productivity goals; and analyze reimbursement trends.
Identify and resolve payment delays, reduce aged receivables, and oversee write-offs and contractual adjustments.
Develop denial-prevention strategies by analyzing denial trends, coordinating appeals, and ensuring timely reconsiderations, corrected claims, and rebilling.
Maintain compliance and documentation with applicable regulations, contracted fee schedules, California Medi-Cal regulations, HIPAA, CMS documentation requirements, and state and federal billing regulations.
Monitor, report, and improve key performance indicators, including net and gross collection rates, days in accounts receivable, payer aging, cash collections, charge lag, denial rates, payment variances, bad debt trends, and productivity metrics.
Provide recommendations to executive leadership for improvements.
Supervise and mentor billing office personnel, establish productivity standards, provide training and development, and foster a collaborative, accountable, high-performing team.
Conduct introductory and annual performance reviews.
Coordinate with billing software vendors, clearinghouses, collection agencies, payment vendors, and insurance representatives, and monitor vendor performance.
Coordinate and oversee internal billing audits, Medicare audits, Medi-Cal audits, ROC audits, and documentation reviews; implement corrective action plans as needed.
Perform other duties as assigned by the Director of Patient Financial & Revenue Cycle.