Job Title: Revenue Cycle Manager

Reports to: CFO

The San Diego American Indian Health Center (SDAIHC) is a patient-centered health home that provides comprehensive medical, dental, behavioral health, and community wellness services that are available to all San Diegans. Founded in May 1979, we honor the wisdom of community leaders who believed urban American Indians living in our city should have community-based health care rooted in traditional cultural values. The vision of our founders lives on after nearly forty years as we continue to grow and provide high quality health care services to a diverse community of all ages and walks of life.

Our Mission

The Mission of San Diego American Indian Health Center is to promote excellence in health care with respect to custom and tradition. Our goal is to reduce the significant health disparities of San Diego’s urban American Indian population by increasing access to care and improving the quality of that care, resulting in increased life expectancy and improved quality of life.

Our Vision

We are a community health center dedicated to embodying the values central to American Indian cultures. This includes respect for our patients, acknowledgement of the whole person, and a focus on working together to ensure health for the individual, and therefore the community.

We invite persons of all tribes, ethnic backgrounds and walks of life to experience the comprehensive care we deliver and to contribute to the services we provide for children, youth, families, adults, and elders.

Hear from our team

Benefits Sheet

Summary: Manage and oversee the FQHC health center billing and collection to ensure effectiveness through in-depth denial analysis and revenue cycle process efficiency

Essential Duties and Responsibilities:

1. Build and mentor a team of biller, collector, and coder
2. Review all visit’s data to ensure all services and diagnosis are accounted for.
3. Develops reports/data to assist in the evaluation of business performance
4. Develops best practice revenue cycle performance benchmark for Federally Qualified Health Center (FQHC)
5. Participates in analysis of monthly/quarterly/annual consolidated financial data, including variance analysis and determination of profitability
6. Assist with budgeting, and forecasting, including participation in business development and financing projects
7. Prepare and assist in Medicare cost report and Medi-Cal reconciliation annual submission 
8. Review Sliding Fees and Fee Schedules to ensure up-to-date
9. Handle ad-hoc reporting and analysis and investigate issues providing explanations and interpretations
10. Review journal entries for revenues and allowance for doubtful accounts during month-end close
11. Perform work in a self-directed manner and works with less structured, more complex issues
12. Act as a resource to others Ad hoc projects
13. Partner with internal and external stakeholders in key business areas related to Revenue Cycle management
14. Work with management and other departments to improve billing workflow
15. Analyze data from multiple sources, including patient accounting data, claims data, and clinical data from electronic medical records, to discover key insights for revenue cycle and operational improvement
16. Review explanation of benefit forms received in reimbursement process.
17. Appeal any incorrect non/under-payments.
18. Follow up on unresolved accounts receivables.
19. Document procedures as needed.
20. Provide required information on time and with a high degree of quality and transparency
21. Ability to work independently and multi-task, with a strong attention to detail
22. Ability to communicate effectively; excellent verbal and written communication skills
23. Strong PC skills, including solid experience with standard Microsoft products
24. Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
25. Performs other duties as assigned by supervisory staff.

Required Qualifications

Education and/or Experience: Sufficient training and experience is required to demonstrate the ability to perform the above duties and responsibilities and to attain the knowledge, skills and abilities listed below. 

• Required Education: Degree in Finance or Accounting or a related field
• Preferred Education: Bachelor in Finance, Accounting, Business, or Healthcare
• Required Experience: 3-5 years of experience in billing, revenue cycle management in health care.
• Preferred Experience: previous experience working in FQHC environment

Additional requirements as listed below:

• Commitment to working in the Native American and surrounding community
• Commitment to community health care
• Familiarity with community health clinics and/or Indian Health Clinics preferred

Language Skills: Able to read and comprehend at a college level; able to communicate professionally in person and in writing.

Reasoning Ability: Able to apply common sense understanding to carry out instructions furnished in written or oral form. Apply logic and reasoning to identify strengths and weaknesses of alternative approaches, solutions or conclusions in order to effectively resolve problems.

Computer Skills: To perform this job successfully, an individual should have knowledge of accounting software, database software, internet software, Microsoft Office applications.

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without accommodation.

• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently lift, carry, push, pull objects, including bodily motion
• Moving on foot to accomplish tasks, particularly from one work site to another
• Substantial movements of the wrists, hands and or/fingers to operate computer and other office equipment such as telephones and printers
• Occasionally ascend/descend stairs to access different departments

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

Acknowledgement: The San Diego American Indian Health Center is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, ancestry, age, marital status, physical or mental disability, or any other protected class, political affiliation, or belief.