Revenue Cycle Management Manager

Revenue Cycle Management Manager

Location:

Mid-Atlantic Region

Job Type: Full-Time

Reports To:

Director of Billing and Credentialing

Bloom Health Centers is seeking a highly organized, detail-oriented, and experienced Revenue Cycle Management Manager to oversee the day-to-day operations of our medical billing and coding department. This position plays a critical role in ensuring accurate and timely billing, optimizing revenue cycle performance, maintaining regulatory compliance, and supporting strong relationships with patients, providers, payers, and internal teams.

The Revenue Cycle Management Manager will serve as the department's subject matter expert for medical billing and coding processes while providing leadership and direction to Billing Specialists and other billing personnel. This individual will oversee the full billing cycle, including coding, charge entry, claims submission, payment posting, accounts receivable follow-up, denials and appeals, and reimbursement management.

The ideal candidate is a proactive problem-solver who can work independently, make sound decisions, identify opportunities for process improvement, and collaborate effectively with company leadership to implement initiatives that improve operational efficiency and cash flow.

• Oversee the daily operations of the billing department, including medical coding, charge entry, claims submission, payment posting, accounts receivable follow-up, collections, and reimbursement management.
• Serve as the department's primary resource and subject matter expert for medical billing and coding processes.
• Review billing and claims for accuracy, completeness, and compliance prior to submission.
• Submit claims to the appropriate insurance payers and monitor claims throughout the reimbursement process.
• Follow up on outstanding, denied, rejected, and underpaid claims using practice management systems, clearinghouses, payer portals, and other applicable systems.
• Prepare and submit appeals and other documentation as needed to support appropriate reimbursement.
• Monitor accounts receivable and identify trends or issues that may negatively impact collections and cash flow.
• Develop and implement strategies to improve collection rates, reduce outstanding receivables, and minimize billing errors and denials.
• Maintain accurate and timely patient insurance and billing documentation.
• Collaborate with other departments to obtain and verify information necessary for accurate billing and claims processing.

• Supervise and provide day-to-day leadership to Billing Specialists and other billing department personnel.
• Assign and prioritize workloads to ensure department responsibilities are completed accurately and within established timelines.
• Train, coach, and support billing staff to promote productivity, accountability, and professional development.
• Coordinate onboarding and ongoing training for new and existing team members on billing systems, policies, procedures, payer requirements, and coding standards.
• Serve as a resource for staff questions and assist with resolving complex billing and coding issues.
• Coordinate team member schedules and time off to maintain appropriate department coverage and ensure continuity of daily operations.
• Promote a collaborative, professional, and high-performing team environment.

• Ensure billing and coding practices comply with applicable federal and state regulations, payer requirements, and organizational policies.
• Stay current on changes to medical billing, coding, reimbursement, and payer regulations and communicate relevant updates to staff and leadership.
• Maintain current resources and reference materials related to coding, documentation, billing, and regulatory requirements.
• Review and update department procedures as needed to maintain compliance and operational effectiveness.
• Perform and/or coordinate physician credentialing activities as assigned.
• Identify compliance risks and recommend corrective actions when necessary.

• Prepare and present detailed billing, accounts receivable, reimbursement, and other financial activity reports.
• Prepare and analyze weekly and monthly billing and financial reports in collaboration with the Practice Administrator, Business Manager, and COO.
• Compile and maintain accurate billing and revenue cycle statistics and performance metrics.
• Monitor departmental…