Revenue Cycle Manager

Department:Revenue Cycle
Reports To: Chief Financial Officer (CFO)
PositionSummary
The Revenue Cycle Manager is responsiblefor overseeing and optimizing all aspects of the revenue cycle for Health CarePartners of South Carolina. This position provides leadership for patientregistration, insurance verification, coding, billing, payment posting,accounts receivable, and collections while ensuring compliance with federal,state, payer, and Federally Qualified Health Center (FQHC) regulations. TheRevenue Cycle Manager collaborates with clinical, administrative, and financeteams to maximize reimbursement, improve operational efficiency, and support apositive patient financial experience.
Essential Duties andResponsibilities
• Lead and oversee all revenue cycle operations,including patient registration, insurance verification, coding, billing,payment posting, accounts receivable, and collections.
• Supervise, mentor, and develop revenue cyclestaff through training, coaching, and performance management.
• Monitor key performance indicators (KPIs),including accounts receivable, denial rates, clean claim rates, and collectionperformance, and implement strategies for continuous improvement.
• Ensure compliance with FQHC billingrequirements, Medicare, Medicaid, commercial payer guidelines, and applicablefederal and state regulations.
• Collaborate with providers, clinical staff, andadministrative departments to promote accurate documentation, coding, andreimbursement.
• Review and resolve complex billing issues, claimdenials, payer disputes, and reimbursement discrepancies.
• Oversee coding accuracy and compliance with CPT,HCPCS, and ICD-10 coding guidelines.
• Prepare revenue cycle reports and performancemetrics for the Chief Financial Officer and executive leadership.
• Identify opportunities to improve workflows,increase operational efficiency, reduce denials, and enhance the patientfinancial experience.
• Maintain current knowledge of healthcarereimbursement regulations, payer policies, and revenue cycle best practices.
• Participate in organizational qualityimprovement initiatives, staff meetings, and leadership activities.
• Perform other duties as assigned.
Education & Experience
• Bachelor's degree in Healthcare Administration,Business Administration, Finance, or a related field required; equivalentexperience may be considered.
• Minimum of five (5) years of progressiveexperience in healthcare revenue cycle management required.
• Experience working in a Federally QualifiedHealth Center (FQHC) or community health center strongly preferred.
• American Academy of Professional Coders (AAPC)certification or equivalent professional coding certification preferred.
• Experience managing billing, coding, accountsreceivable, insurance claims, and reimbursement processes required.
Knowledge, Skills, and Abilities
• Comprehensive knowledge of healthcare revenuecycle operations, medical billing, coding, reimbursement methodologies, andpayer regulations.
• Knowledge of CPT, HCPCS, ICD-10 coding,Medicare, Medicaid, commercial insurance, and FQHC billing requirements.
• Strong leadership, analytical, organizational,and problem-solving skills.
• Excellent communication and interpersonal skillswith the ability to collaborate effectively across departments.
• Proficiency in Electronic Health Record (EHR),practice management, billing software, Microsoft Office, and reporting tools.
• Ability to analyze financial and operationaldata, identify trends, and implement effective process improvements.
• Knowledge of HIPAA regulations and the abilityto maintain the confidentiality, security, and integrity of patientinformation.