Revenue Cycle Manager

Job Purpose: Responsible for managing the operations of Appeals, Payment Posting, Collections, and Financial Counseling teams. Ensures adherence to established Standard Operating Procedures (SOPs) and achievement of Key Performance Indicators (KPIs) to maintain revenue cycle efficiency. Works collaboratively with leadership to keep Accounts Receivable (A/R) within organizational targets and provides technical oversight for billing and appeals processes across all payers and identifies variances to goals and RCM trends.

• Revenue Cycle Oversight:
  Direct submission of claims and appeals for denied claims, ensuring compliance with SOPs.
• KPI Monitoring:
  Maintain performance metrics such as:
  • Days in A/R within target range
  • Clean Claim Rate
  • Denial Rate
  • Appeals Resolution Turnaround
• Workflow Management:
  Organize daily operations to minimize backlog and optimize productivity.
• Staff Leadership:
  Interview, hire, evaluate, discipline, and coach employees. Conduct regular team meetings for communication and accountability.
• Compliance &
  
  Education:
  
  Stay current on payer regulations, coding updates, and appeal trends. Train staff to ensure adherence to SOPs and compliance standards.
• Reporting:
  Provide monthly KPI dashboards and production reports to leadership.
• Continuous Improvement:
  Identify process gaps and implement improvements to enhance efficiency and reduce risk.

• Professional demeanor, customer-focused approach, and ability to foster teamwork.
• Commitment to ongoing education and compliance with federal, state, and local regulations.
• Proficiency in Athena EMR systems and Microsoft Office Suite.

Reports to Revenue Cycle Director

Requires a high school diploma or GED; bachelor’s degree in healthcare administration or related field preferred.

• Minimum 5 years of experience in revenue cycle management (RCM) and 3 years in leadership or management role. Strong background in pain management preferred.
• CPC certified or 3 years of coding experience.