Manager of Revenue Cycle

The Manager of Revenue Cycle is responsible for overseeing and optimizing the entire revenue cycle process at IHC, ensuring efficient, accurate, and compliant billing and collections. This position plays a critical role in sustaining the financial health of the organization by managing all aspects of revenue generation, reimbursement, and payment posting. The Manager of Revenue Cycle will work closely with clinical, administrative, and financial teams to enhance revenue performance, ensure compliance with federal and state regulations, and implement industry best practices.

Under the general direction of the CFO, the Manager of Revenue Cycle is responsible for the management of third-party payor contracts (Managed Care Entities) and maintenance of all Accounts Receivable and Billing related record-keeping systems and involves a technical independence guided by administrative routines, requirements of others and established schedule. The position provides guidance of a functional nature to staff members directly involved with the IHC finance, both in the corporate office and at the sites.

Position supervises the billing department staff. Working closely with IHC health center operations team and the IT department,, the Manager of Revenue Cycle participates as a member of a team who develops and implements, maintains, and evaluates corporate information systems.

Performance will be evaluated based on meeting specific goals, productivity measures, employee satisfaction scores, and other quality indicators for this position such as: IHC strategic objectives; site strategic objectives; functional capabilities; leadership and/or employee capabilities; IHC commitments, quality measures, and productivity measures.

Requires expert knowledge of an extensive body of managed care contracting, medical billing and medical coding rules and regulations, specifically related to state Medicaid reimbursement – Healthy Indiana Program (HIP) and Medicaid Contract Offices (MCOs) and Medicare (CMS). Requires knowledge of, precedents, procedures, and past practices applicable to medical billing and medical coding and cost recovery along with knowledge of IHC’s structure, goals, and specialized terminology.

Requires knowledge of CPT and ICD coding. Requires knowledge of managed care and third-party payer contract negotiations including value-based terms. Knowledge permits the employee to develop new approaches or improve current administrative operations within the confines of the laws and regulations.

• Implement and manage third-party contracts
• Monitor third-party contracts
• Analyze data to determine rates for contract negotiations
• Work with CFO to negotiate new and renewal contracts
• Evaluate payor rate proposals
• Review contracts ensuring terms are agreed by all parties
• Work with CFO to terminate contracts, as needed
• Maintain and update as needed detailed contract profiles, including key terms
• Meet as necessary with CFO and/or CEO regarding contract updates/status
• Guide internal resolution to payor issues, including under payment

• Completion of all 2nd and 3rd party requests for payments forms
• Preparation of all data input forms for the accounts receivable
• Manages accounts receivables and past due accounts
• Conducts monthly, quarterly, and annual AR “scrub”
• Manages provider credentialing, privileging, and MCO panel award, includes working with IHC’s Credentialing Specialist and enrollment vendor

• Compiles information for periodic financial reports
• Assists the CFO on special projects as needed
• Analyzes and presents data in a format conducive to…