Manager, Revenue Analysis

Job Summary

Reports to the Director of Revenue Analysis. Performs root cause identification and process improvement related to any component of the revenue cycle stream related to physicians practices. Reviews and investigate errors, determine root causes and develop solutions by working with staff/departments across the enterprise. Provide strategic and tactical planning, analysis, continuous quality and productivity improvements in order to meet key performance indicators established for the organization, and effectively achieve performance goals through collaborating with internal and external stakeholders. They will be responsible for analyzing all revenue cycle operational activities, which includes charge capture, medical coding, claims management, billing, collections, customer service, denial management, cash posting, follow-up, self-pay bad debt placement, contract management and reimbursement. Management position requires leading and directing teams, setting objectives, overseeing operations, and ensuring the achievement of business goals, while also focusing on employee development and performance.

Experience: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Minimum of five (5) years in provider based process improvement, project management, and Revenue Cycle Management
• Thorough knowledge of complex project management processes, tools, techniques and methodologies to lead multiple sites.
• In-depth knowledge of healthcare billing practices, reimbursement methodologies, and regulatory requirements.
• Must be a strong leader with good interpersonal relationships.
• Demonstrated ability to determine the key business issues and develop appropriate action plans from multidisciplinary perspectives.
• Advanced interpersonal communication skills, verbal and written.
• Strong Leadership skills in overseeing daily operations, setting goals and objectives in addition to ensuring team members are meeting performance expectation.
• Developing and implementing team strategies.
• Cerner Experience a plus

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Qualifications

• Required - Associates Degree with at least 5 years experience in Healthcare Revenue Cycle Management
• Preferred - Bachelor's Degree in area of specialty

Licenses/Certificates:

• HFMA CRCR Certification required within 12 months of employment

Job Knowledge & Skills:

• Project Management: Oversee the end-to-end revenue lifecycle from patient registration and charge capture to claim submission, payment posting, and collections working with our shared services team.
• Denial Management: Analyze claim denials and underpayments, lead the appeals process, and implement workflow changes to prevent future rejections.
• Team Leadership: Hire, train, mentor, and evaluate billing and collections personnel.
• Financial Reporting: Monitor Key Performance Indicators (KPIs) such as A/R days and unbilled claims, presenting actionable financial performance reports to senior management.
• Compliance: Ensure all medical billing, coding, and documentation adhere to federal, state, and payer- specific guidelines (Medicare/Medicaid).
• Cross-Functional Collaboration: Partner with clinical, finance, and IT departments to optimize billing software and workflows.