Summary
The Revenue Cycle Manager is responsible for overseeing financial tracking, billing processes, and insurance operations across all programs. This role ensures accurate revenue cycle management, compliance with Medicaid and commercial insurance requirements, and supports organizational financial health through reporting, auditing, and process improvement
Qualifications
· Required:Education: Bachelor’s degree required.
· Experience: 3–5+ years in revenue cycle or healthcare billing. Experience with Medicaid, behavioral/therapy billing.
Responsibilities
· Billing
o Coordinate with the billing team on corrections and resubmissions
o Ensure timely and accurate claim submission
o Review billing data from EMR
o Attend all applicable insurance workshops
o Remain up to date with MMA and private insurance changes
o Ensure compliance with payer requirements
· Revenue/Remittance
o Create and manage program invoicing (contracts, private pay)
o Seek out additional revenue sources through Medicaid and commercial insurance
o Conduct internal audit reviews with all Program Directors to ensure streamlined processes
o Assist Program Directors on additional revenue generation opportunities.
o Works with the Development team for revenue generation opportunities
· Credentialing
o Maintain group NPIs
o Maintain payer credentialing (Medicaid, commercial)
o Maintain therapeutic Medicaid portals
o Manage payer portals (Availity, Payspan, etc.)
· Reporting
o Maintain/record all productivity for each therapy department
o Create month and year-end projections with the program director's oversight
o Manage and track all contractual adjustments (BT, CT, CBH)
o other duties as assigned
Easterseals Southwest Florida is dedicated to providing exceptional service to children, youth and adults with disabilities as well as support to their families. We offer the highest quality of care throughout our clients’ lives so they can enjoy access, opportunities and more dynamic life choices. The agency was founded in 1946 and for more than 76 years has offered therapies, services and enrichments across our region.
Through public and private funding as well as philanthropy, Easterseals administers a variety of therapies -- occupational, physical, speech and more -- as well as educational opportunities for the young and not-so-young: The Lily School Pre-K, ABA Academy, VIP High School, Adult Employment Services & Day Training as well as enrichment programs in art, music and performing arts. Community partnerships enhance offerings and include equine therapy at InStride Therapy and projects in organic farming with Operation Eco Vets garden on the Easterseals campus. Therapists are also actively enhancing therapies and services within the autism spectrum, allowing Easterseals to serve this growing community.
Easterseals SWFL strives to be an Employer-of-Choice and is proud to offer our employees a rich, comprehensive and competitive benefits package including, but not limited to, options for a medical plan, dental and/or vision plans, paid time off, 403B retirement plan, and paid holidays.