Revenue Capture Manager

Location: West Long Branch

About the Role:

The Revenue Capture Manager plays a critical role in optimizing the financial performance of healthcare organizations by ensuring accurate and timely capture of all billable services. This position is responsible for overseeing revenue cycle processes, identifying gaps in documentation and coding, and collaborating with clinical and administrative teams to maximize reimbursement. The manager will analyze revenue data to detect trends, implement corrective actions, and drive continuous improvement initiatives.

They will also ensure compliance with healthcare regulations and payer requirements to minimize denials and audit risks. Ultimately, this role contributes to the organization's financial health by enhancing revenue integrity and supporting sustainable growth.

Minimum Qualifications:

• Bachelor's degree in Health Administration, Business, Finance, or a related field.
• Minimum of 5 years of experience in healthcare revenue cycle management or medical billing and coding.
• Strong knowledge of medical coding systems such as ICD-10, CPT, and HCPCS.
• Familiarity with healthcare regulations including HIPAA and payer-specific billing requirements.
• Proficiency in revenue cycle management software and data analysis tools.

Preferred Qualifications:

• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) credential.
• Experience working in a hospital or large healthcare system environment.
• Advanced skills in data analytics and reporting platforms such as SQL, Tableau, or Power BI.
• Project management experience with a track record of leading process improvement initiatives.
• Master's degree in Healthcare Administration or related discipline.

Responsibilities:

• Manage and oversee the revenue capture process, including documentation, coding, and billing accuracy.
• Collaborate with clinical staff to ensure complete and compliant documentation of services rendered.
• Analyze revenue cycle data to identify trends, discrepancies, and opportunities for improvement.
• Develop and implement strategies to reduce claim denials and improve reimbursement rates.
• Train and support staff on best practices related to revenue capture and compliance.
• Coordinate with compliance and audit teams to ensure adherence to regulatory requirements.
• Prepare regular reports on revenue capture performance and present findings to senior management.
• Lead initiatives to optimize workflows and integrate technology solutions that enhance revenue capture.

Skills:

The Revenue Capture Manager utilizes strong analytical skills daily to interpret complex billing data and identify areas for revenue enhancement. Effective communication skills are essential for collaborating with clinical teams to ensure accurate documentation and for training staff on compliance and best practices. Proficiency with coding systems and revenue cycle software enables the manager to oversee accurate charge capture and billing processes.

Leadership and project management skills are applied to drive initiatives that improve operational efficiency and reduce denials. Additionally, knowledge of healthcare regulations ensures that all revenue capture activities comply with legal and payer requirements, safeguarding the organization from financial risk.