About the Role:

The Manager of Revenue Cycle Management plays a critical role in overseeing and optimizing the entire revenue cycle process to ensure timely and accurate billing, collections, and reimbursement for healthcare services. This position is responsible for leading a team that manages patient registration, insurance verification, coding, claims submission, payment posting, and denial management. The manager will collaborate closely with clinical, financial, and administrative departments to identify process improvements and implement best practices that enhance revenue integrity and operational efficiency. They will analyze financial data and key performance indicators to develop strategies that reduce accounts receivable days and improve cash flow. Ultimately, this role ensures compliance with regulatory requirements while maximizing revenue capture and supporting the financial health of the organization.

Minimum Qualifications:

• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.
• Minimum of 5 years of experience in healthcare revenue cycle management or medical billing, with at least 2 years in a supervisory or managerial role.
• Strong knowledge of medical billing, coding standards (ICD-10, CPT), and healthcare reimbursement methodologies.
• Familiarity with healthcare regulations such as HIPAA and payer-specific billing requirements.
• Proficiency in revenue cycle management software and electronic health record (EHR) systems.

Preferred Qualifications:

• Master's degree in Healthcare Administration, Business Administration, or a related discipline.
• Certification such as Certified Revenue Cycle Professional (CRCP) or Certified Professional Coder (CPC).
• Experience working with multiple payer contracts including Medicare, Medicaid, and commercial insurers.
• Demonstrated success in leading process improvement initiatives and change management.
• Strong analytical skills with experience using data analytics tools to drive decision-making.

Responsibilities:

• Lead and supervise the revenue cycle team, providing guidance, training, and performance evaluations to ensure high-quality work and professional development.
• Oversee patient registration, insurance verification, coding accuracy, claims submission, payment posting, and denial management processes to optimize revenue collection.
• Collaborate with clinical and administrative departments to streamline workflows, resolve billing issues, and implement process improvements.
• Monitor key performance indicators such as days in accounts receivable, denial rates, and collection percentages to identify trends and develop corrective action plans.
• Ensure compliance with healthcare regulations, payer requirements, and internal policies related to billing and revenue cycle management.
• Manage relationships with insurance payers and third-party vendors to resolve disputes and negotiate contract terms when necessary.
• Prepare and present regular reports on revenue cycle performance to senior leadership, highlighting challenges and opportunities for improvement.

Skills:

The Manager of Revenue Cycle Management utilizes strong leadership and communication skills daily to effectively manage and motivate their team, ensuring alignment with organizational goals. Analytical skills are essential for interpreting financial data and identifying trends that impact revenue performance, enabling the manager to develop targeted strategies for improvement. Proficiency with revenue cycle software and EHR systems allows the manager to oversee accurate billing and claims processing efficiently. Knowledge of medical coding and billing regulations ensures compliance and reduces the risk of denials or audits. Additionally, negotiation and problem-solving skills are frequently applied when working with payers and resolving complex billing issues to maximize reimbursement.