Patient Revenue Cycle Manager

Job Overview
We are seeking a dynamic and detail-oriented Patient Revenue Cycle Manager to lead and optimize the end-to-end revenue cycle processes within our healthcare organization. In this pivotal role, you will oversee billing, coding, claims submission, payment posting, and accounts receivable management to ensure maximum reimbursement and financial health. Your leadership will drive efficiency, accuracy, and compliance across all revenue cycle functions, empowering the organization to deliver exceptional patient care while maintaining fiscal responsibility. This position offers an exciting opportunity to influence operational excellence and foster a collaborative environment focused on continuous improvement.

Responsibilities

• Lead the coordination and management of all revenue cycle activities, including patient registration, billing, coding, claims processing, and collections.
• Develop and implement policies and procedures that enhance workflow efficiency, accuracy, and compliance with healthcare regulations such as HIPAA and payer-specific requirements.
• Monitor key performance indicators (KPIs) related to accounts receivable days, denial rates, collection rates, and overall revenue cycle performance; analyze data to identify areas for improvement.
• Collaborate with clinical staff, billing teams, payers, and third-party vendors to resolve claim denials promptly and reduce billing errors.
• Provide training, mentorship, and ongoing support to revenue cycle staff to ensure adherence to best practices and professional development.
• Oversee the implementation of revenue cycle management software systems; ensure data integrity and security are maintained at all times.
• Stay current with industry trends, payer policies, coding updates, and regulatory changes that impact revenue cycle operations.
• Design the functions of our Authorizations and Billing department(s)
• Roll out and follow up on the new process and functions with all provider teams.
• Support ongoing continuous improvement within the Auth and Billing department and, as appropriate, the organizational processes/workflows
• Direct supervision of all Auth and Billing staff: timecards, PTO requests, policy and procedure adherence
• Perform all staff performance reviews, development, and progressive discipline as needed and in accordance with practice policy and guidelines
• Develop training and education tools for patients, staff, and providers
• Represent the Auth and Billing at all required external meetings and contacts to include representation with the payers
• Remain an active participating member of the Core Leadership Team- representing the needs of patients and the Auth and Billing departments
• Manage and communicate professionally, timely, and clearly via phone, in-person, email, and practice EMR (Athena)
• Assist with verifying insurance eligibility and coverage information
• Monitor and advise staff on payer policy updates
• Monitor/manage refund and collection policies
• Charge Entry and claims processing management
• Run monthly financial and miscellaneous reports
• Assists in updating and creating office policies and protocols
• Reviewing financial hardship applications
• Oversee the hiring and training of staff
• Conduct monthly A/R Reviews with billing services and Executive Director, discuss and direct actions for problem accounts and identify trends and issues impacting billing efficiency and performance
• Coordinates Clinical Documentation Compliance audits reviews and improvements
• Assists with Insurance Bundle Programs
• EMR enrollment worklist/dashboard tasks
• Updating insurance and self-pay fee schedules in EMR (Athena)
• Review prepayment list for patient refunds
• Review claims on hold and provide direction
• Pull bank deposits and upload payments and correspondence to EMR as needed
• Manage unpostables in the EMR, including identifying and resolving missing payments and EOBs
• Maintain administrative access for majority of insurance portals for organizational users
• Oversee credentialing of providers and locations
• Serve as point of contact for Accountable Care Organizations
• Perform insurance appeals as required
• Create and update allowable fee schedules in EMR (Athena)

Requirements

• High school diploma, bachelor’s degree in Healthcare Administration preferred
• Certified Professional Coder (CPC), through AAPC or The Certified Coding Specialist (CCS) through AHIMA required
• Proven experience managing healthcare revenue cycle processes for 3 years or more in a fast-paced environment
• Strong knowledge of medical billing practices, coding (ICD-10, CPT), insurance payers’ requirements, and healthcare compliance standards
• Excellent leadership skills with the ability to motivate teams and foster a collaborative work environment
• Analytical mindset with proficiency in revenue cycle management software systems (e.g., Athena) and data analysis tools
• Exceptional communication skills to effectively liaise with internal teams and external stakeholders such as payers and regulatory bodies
• Ability to prioritize tasks efficiently while maintaining attention to detail in a high-volume setting. Join us in transforming healthcare revenue management through innovative leadership! We are committed to supporting your professional growth while ensuring you have the resources needed to succeed in this vital role.

Pay: $60,000.00 - $70,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $60,000 - $70,000