REVENUE CYCLE MANAGER

Description:

Summary of Role

The Revenue Cycle Manager is responsible for managing the day-to-day operations and performance of OAW’s revenue cycle functions. This position provides hands-on leadership to the revenue cycle team and ensures processes related to insurance verification, billing, coding, claims submission, payment posting, accounts receivable, denials, and collections are performed accurately, efficiently, and in accordance with applicable requirements.

The Revenue Cycle Manager establishes clear expectations, monitors performance, develops staff, identifies opportunities for improvement, and works collaboratively with leadership and other departments to support timely reimbursement, strong financial performance, and an exceptional patient experience.

Key Responsibilities

• Manage daily revenue cycle operations, including insurance verification, coding, charge capture, billing, claims submission, payment posting, accounts receivable, denials, and collections.
• Analyze financial and operational reports and identify trends, risks, weaknesses, and opportunities for improvement.
• Monitor key performance indicators (KPIs), accounts receivable, denials, collections, and payer trends; identify issues and implement corrective actions and process improvements.
• Ensure accurate, timely, and compliant billing and reimbursement practices in accordance with payer, Medicare, Medicaid, and applicable regulatory requirements.
• Develop, implement, and maintain efficient revenue cycle policies, procedures, workflows, and internal controls.
• Lead, coach, and develop revenue cycle staff while establishing clear expectations and ensuring accountability for productivity, quality, and departmental goals.
• Collaborate with Finance, clinical teams, providers, and operational leadership to resolve revenue cycle issues and support organizational goals.
• Monitor payer activity and reimbursement issues, escalating significant concerns and supporting payer contract and reimbursement analysis as needed.
• Optimize the use of revenue cycle systems, clearinghouses, payer portals, reporting tools, and technology to improve efficiency and collections.
• Provide revenue cycle education and serve as a resource to staff, providers, and leadership.
• Promote a positive patient experience by ensuring billing questions and escalated concerns are handled accurately, professionally, and timely.
• Support departmental staffing, resource management, and budget expectations while fostering a culture of accountability, teamwork, professionalism, and continuous improvement.
• Perform other duties as assigned.

Requirements:

Qualifications

• Bachelor’s degree in Business Administration, Healthcare Administration, Finance, Accounting, or a related field preferred. Relevant education and significant revenue cycle experience may be considered in lieu of a degree.
• Minimum of three to five years of progressively responsible healthcare revenue cycle experience preferred.
• Previous supervisory, team lead, or management experience strongly preferred.
• Experience in physician practice, specialty medical practice, ambulatory surgery, or a similar healthcare environment preferred.
• Experience working with practice management systems, electronic health records, clearinghouses, payer portals, and revenue cycle reporting tools preferred.
• Proficient in Microsoft Office Suite