Revenue Cycle Services Manager

Exer Medical Corporation•El Segundo, CA

1d•Hybrid

About The Position

Revenue Cycle Services Manager – Urgent Care Position Summary This role is responsible for end-to-end revenue cycle oversight and performance of a high-volume, fast-paced urgent care environment. This role manages all revenue cycle functions from charge capture through payment posting, denial management, patient billing, and collections. This role ensures compliant, timely, and accurate billing practices; optimizes cash flow; enhances the patient financial experience; and leads internal and outsourced teams to achieve best-in-class urgent care revenue cycle outcomes.

Requirements

Bachelor’s degree in Healthcare Administration, Business, Finance, or related field (or equivalent experience).
5+ years of progressive experience in professional (outpatient) billing, with significant exposure to urgent care or high-volume ambulatory settings.
2+ years of people management and/or outsourced vendor management experience.
Strong knowledge of urgent care coding and billing, including E/M guidelines, procedures, vaccines, occupational medicine, and payer-specific policies.
Proven ability to manage KPIs, analyze trends, and improve revenue cycle performance in a fast-paced environment.
Familiarity with California payer requirements and regulatory considerations.

Nice To Haves

Experience working with urgent care EHR/practice management systems and clearinghouses.
Professional certifications such as CPC, CPB, CRCR, or similar.
Experience managing offshore or hybrid revenue cycle teams.

Responsibilities

Oversee daily professional billing operations for urgent care services, including charge capture, visit-level coding coordination, claim submission, payment posting, denial management, credit balances, refunds, and patient billing.
Manage workflows specific to urgent care encounters, including high-volume E/M services, procedures, vaccines, occupational medicine, and ancillary services.
Ensure timely and accurate billing for multiple business lines including medical insurance, Self-Pay, Workers’ Compensation, Occupation Medicine, and Personal Injury visits.
Partner closely with Clinical Operations, Coding, and Front-End teams to ensure accurate documentation, point-of-service collections, eligibility verification, and authorization workflows appropriate for urgent care.
Implement denial prevention workflows focused on common urgent care denials such as eligibility, modifier usage, bundling, records request, etc.
Enforce A/R follow up strategies for resolving denials or no response timely through one-touch resolutions.
Monitor underpayments and enforce payer contract compliance.
Establish escalation processes for recurring payer issues and reimbursement delays.
Ensure compliance with CMS, state regulations, HIPAA, and payer-specific urgent care billing requirements.
Maintain adherence to professional billing rules, CPT/HCPCS coding, ICD-10-CM diagnosis accuracy, NCCI edits, LCD/NCDs, and urgent care-specific payer guidelines.
Develop and maintain QA programs, including encounter audits, denial root-cause analysis, and corrective action plans.
Lead, coach, and develop revenue cycle team members to create internal growth opportunities resulting in a tenured team.
Manage onshore, offshore, or hybrid staffing models, ensuring productivity, accuracy, and service-level expectations are met.
Establish standardized training programs for urgent care billing workflows, payer rules, and system usage.
Manage revenue cycle related vendors, including contract oversight, SLAs, KPIs, QA results, and continuous improvement initiatives.
Serve as a subject-matter expert for urgent care billing systems, practice management platforms, clearinghouses, and payer portals.
Partner with IT and EHR teams to optimize charge capture, automation, edits, and reporting specific to urgent care encounters.
Monitor and analyze key urgent care revenue cycle KPIs, including net collection rate, first-pass yield, denial rate, days in A/R, aging, write-offs, and patient collections.
Prepare and present performance dashboards and trend analyses to revenue cycle and operations leadership.
Identify revenue leakage tied to front-end errors, documentation gaps, or payer rule changes and implement remediation plans.
Lead process-improvement initiatives to standardize urgent care billing workflows across multiple clinics.
Support new clinic openings, payer go-lives, and service line expansions from a billing and revenue readiness perspective.
Drive scalable processes that support growth while maintaining compliance and financial performance.