Revenue Cycle Manager

Description

This position oversees the entire revenue cycle—from claims processing and clearinghouse operations to A/R management, payer relations, compliance, and staff development. The Revenue Cycle Manager collaborates closely with clinical, operational, and administrative leadership to ensure timely and accurate billing, maximize reimbursement, and uphold high standards of compliance and service.

This position oversees the entire revenue cycle—from claims processing and clearinghouse operations to A/R management, payer relations, compliance, and staff development. The Revenue Cycle Manager collaborates closely with clinical, operational, and administrative leadership to ensure timely and accurate billing, maximize reimbursement, and uphold high standards of compliance and service.

• Minimum 5 years of medical billing or business office management, with at least 2–3 years in a supervisory or department leadership role.
• Experience with FQHC billing preferred, experience with Medicare/Medicaid, commercial payer rules, and compliance requirements.
• Proficiency in EMR billing systems, clearinghouse platforms, and Microsoft Office applications.

• Strong analytical and problem-solving skills, including ability to interpret financial data and identify trends.
• Excellent communication, presentation, and organizational abilities.
• Demonstrated leadership, professionalism, integrity, and adaptability.
• Ability to establish priorities, coordinate work activities, and manage competing deadlines.

• Bachelor’s degree in business, Healthcare Administration, Finance, or related field; or equivalent progressive experience in revenue-cycle leadership.

• Direct and manage all components of the revenue cycle, ensuring alignment with BRHC goals and FQHC requirements.
• Develop, implement, and maintain billing and revenue cycle standard operating procedures (SOPs).
• Monitor revenue performance, analyze trends, and provide monthly reports, metrics, and recommendations to leadership.

• Oversee claims submission, clearinghouse workflows, and resolution of rejected/denied claims.
• Ensure compliance with Medicare, Medicaid, and commercial payer billing requirements, with a strong focus on FQHC regulations.
• Act as EMR billing super-user and co-administrator, partnering with the CAS for issue resolution and system optimization.

• Manage A/R aging, identify underpayments, determine root causes, and implement corrective actions.
• Conduct regular internal audits of coding and billing accuracy; provide coaching and education to staff.
• Monitor open encounters and ensure timely completion to support accurate billing.

• Hire, train, supervise, and evaluate billing staff, fostering an environment of accountability, teamwork, and continuous improvement.
• Provide ongoing staff education regarding billing best practices, regulatory updates, and workflow expectations.

• Work with clinical and administrative teams to streamline processes and improve revenue cycle outcomes.
• Maintain strong relationships with payers, vendors, coding consultants, credentialing partners, and outside billing resources.

• Oversee provider insurance credentialing processes managed through BRHC’s contracted credentialing agency.
• Supervise relationships and performance of outside payment posting vendors and contracted collection agencies.

• May provide backup for other Health Center functions as needed.
• Performs other duties as assigned.

• Be committed to the mission and values of the Bucksport Regional Health Center.
• Work as a member of the Finance team in the performance of duties.
• Be punctual for scheduled work and use time appropriately.
• Work in harmonious relationships with all staff, patients, vendors and others.
• Perform duties in a conscientious, cooperative manner.
• Perform the required amount of work in a timely fashion with a minimum of errors.
• Be neat and…