- Position: Revenue Cycle Manager
- Location: Remote (U.S.) or Wichita, KS (flexible hybrid)
- Hours: Monday- Friday 8 am- 5 pm
- Up to 10% travel required
Position:
The Revenue Cycle Manager, Private Duty Nursing (PDN), leads and optimizes the end-to-end revenue cycle function, overseeing insurance verification, authorizations, billing, claims processing, accounts receivable, denials management, collections, reimbursement, and payment resolution. This role provides direct leadership to billing and collections teams, driving productivity, quality, compliance, and overall revenue cycle performance. They establish standardized processes across markets while ensuring payer- and state-specific requirements are met, and partners closely with Intake, Branch Operations, payers, and cross-functional stakeholders to improve revenue readiness, resolve reimbursement challenges, remove operational barriers, and support timely, accurate revenue realization.
- Leads the centralized PDN revenue cycle operation, including insurance verification, authorization activities, billing, claims, accounts receivable, denials, collections, and reimbursement
- Oversees Biller operations, including insurance verification, authorization requests, follow-up, entry and renewal, pre-bill review, claim creation/submission, and claim rejection resolution
- Oversees Collector operations, including accounts receivable, payer follow-up, denials, appeals, underpayments, reimbursement variances, credit balances, patient balances, and account resolution
- Establishes Biller-to-Collector handoffs and clear ownership throughout the claim-to-cash lifecycle
- Develops and maintains revenue cycle policies, procedures, controls, audit processes, and standardized workflows across markets while supporting state- and payer-specific requirements
- Monitors claims, AR aging, denials, collections, reimbursement, payment variances, bad debt, workload, productivity, quality, and capacity across revenue cycle functions
- Leads root-cause analysis and corrective actions for claim, denial, reimbursement, and AR issues, including payer escalations and contract/reimbursement management
- Develops state, payer, and EVV subject matter expertise and cross-training programs to support continuity and workload flexibility
- Partners with the Intake & Revenue Readiness Manager and Branch Operations to address cross-functional barriers, recurring upstream issues, and revenue readiness opportunities
- Coordinates revenue cycle integration for new locations and programs, while reviewing KPIs, performance trends, and priorities with operational leadership
Qualifications:
- Bachelor's degree in business administration, healthcare administration, finance, accounting, or a related field; equivalent combination of education and relevant experience considered
- Seven (7) years of progressive experience in home healthcare revenue cycle, medical billing, accounts receivable, reimbursement, or a related function
Preferred:
- Two (2) years of leadership or supervisory experience preferred
- Experience with payer contracts, contract interpretation, or payer relationship management preferred
- Experience in home healthcare, private duty nursing, or another complex healthcare reimbursement environment preferred
- Demonstrated experience with government and commercial payers, including claims submission and follow-up, denials and appeals, reimbursement, collections, and payer requirements
- Experience analyzing revenue cycle performance, identifying root causes of reimbursement issues, and implementing process improvements
The Company:
Pediatric Home Service is a pediatric home health agency that has provided high quality DME and nursing services to children that are medically fragile since 1990. Our services allow our clients to remain and thrive in their homes, schools, and communities. The majority of the clients we serve are age's birth through 21 years old and have a variety of technologies that might include a trach, ventilator or g-tube.
Benefits:
- Generous Paid Time Off (PTO) for full time employees to ensure a healthy work-life balance
- 401(k) Matching to help secure your future
- Tuition Reimbursement to support your educational and professional growth
- Professional Development & Learning Opportunities to expand your skills and knowledge in pediatric care
- A supportive and fulfilling work environment where your contributions directly impact children's health and well-being
