Revenue Cycle Manager (Onsite/Hybrid)

Revenue Cycle Manager The Revenue Cycle Manager is responsible for overseeing and optimizing all components of the health center revenue cycle to ensure accurate, timely, and compliant billing, collections, and reimbursement. This role provides leadership over patient accounts, coding, claims submission, payment posting, denials management, and accounts receivable processes while ensuring compliance with payer requirements, federal and state regulations, and organizational policies. The Revenue Cycle Manager partners closely with clinical leadership, billing staff, and external vendors to support financial sustainability, operational efficiency, and high-quality patient care. Revenue Cycle Operations and Oversight Estimated Effort: 60% Oversee all revenue cycle functions, including patient registration, charge capture, coding, claims submission, payment posting, denials management, refunds, and accounts receivable follow-up. Monitor daily, weekly, and monthly revenue cycle performance metrics to ensure timely reimbursement and cash flow. Ensure claims are submitted accurately and within payer timelines to minimize denials and rework. Analyze denial trends, identify root causes, and implement corrective action plans to improve first-pass resolution rates. Ensure compliance with Medicare, Medicaid, commercial payer, and managed care billing requirements. Oversee charge master accuracy and maintenance in collaboration with clinical and finance leadership. Ensure timely resolution of patient credit balances and refunds in compliance with regulatory and payer requirements. Maintain effective internal controls to safeguard patient financial information and organizational assets. Collaborate with IT and EHR vendors to optimize revenue cycle workflows and system functionality. Support audits, desk reviews, and monitoring visits related to billing and reimbursement activities. Leadership, Training, and Collaboration Estimated Effort: 25% Directly supervise revenue cycle staff, including billing specialists, coders, and accounts receivable personnel. Recruit, train, coach, and evaluate staff to ensure consistent performance and compliance with best practices. Develop and maintain standard operating procedures (SOPs) for all revenue cycle processes. Serve as a subject matter expert for billing, coding, and reimbursement questions across the organization. Collaborate with clinical leaders, providers, and front-desk staff to improve documentation, charge capture, and billing accuracy. Provide ongoing education and training related to payer rules, regulatory updates, and revenue cycle best practices. Financial Analysis and Reporting Estimated Effort: 10% Prepare and present regular revenue cycle reports to executive leadership, including key performance indicators, denial trends, and collection metrics. Analyze payer mix, reimbursement rates, and collection performance to support strategic and budgetary decision-making. Identify opportunities for process improvement, automation, and cost containment within the revenue cycle. Service and Other Responsibilities Estimated Effort: 5% Participate in CAC and VVHC committees, work groups, and service teams as assigned. Attend trainings, conferences, and meetings related to healthcare billing, compliance, and revenue cycle management. Perform additional duties as assigned to support organizational goals and financial sustainability. Minimum Requirements Education: Bachelor's degree in Accounting, Finance, Business Administration, Healthcare Administration, or a related field required. An equivalent combination of education and experience may be considered. Job-Related Experience: Minimum of five (5) years of experience in healthcare revenue cycle management Demonstrated experience with Medicaid, Medicare, and commercial payer billing People Management Experience: Minimum of three (3) years of supervisory or leadership experience. Licenses, Certifications, and Accreditations: None required. Preferred Qualifications Experience working in a Federally Qualified Health Center (FQHC) Knowledge of Uniform Grant Guidance (UGG) and HRSA billing requirements Certification in healthcare billing, coding, or revenue cycle management Working Conditions This position operates in a well-lighted office environment with extensive computer use. Occasional local or regional travel may be required for meetings or training. Work is deadline-driven and fast-paced, with moderate-to-high levels of stress related to billing timelines, payer regulations, and financial performance.

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