Revenue Cycle Manager, Critical Access Hospital Engagement

About Covered

Covered Health is a revenue cycle team that pairs experienced RCM specialists with smart automation and AI tools built to make their work easier. Our software has reduced coding denials by 46.5% for clients like Ogden Clinic by catching issues at the point of claim creation. It also helps automate appeals by pulling in individual payer policies so AR work moves faster.

We started this work after the founder’s brother faced a cascade of denials over eight surgeries for colitis, resulting in $1 million in bills. Our mission is simple: get providers paid correctly so patients don’t get the bill.

This role supports a rural critical access hospital engagement where Covered has assumed management of the hospital’s revenue cycle department. You will help stabilize billing operations, work down aged accounts receivable, and build the workflows and training that the hospital’s own team will eventually take over. This is hands-on, high-impact work. The results show up in the hospital’s cash flow and in patients not receiving bills they shouldn’t.

Position Overview

We are hiring one Revenue Cycle Manager to lead day-to-day revenue cycle operations for a critical access hospital in Kanab, Utah, under Covered Health’s interim management engagement. This role requires significantly more experience than our AR Specialist positions. Full benefits through Covered Health.

The Revenue Cycle Manager owns the daily operation of the hospital’s business office: claim submission, edits and rejections, denials and appeals, insurance and patient AR follow-up, cash posting, and bad debt and collection agency review. This is a working manager role. You will supervise a small blended team of Covered remote specialists and onsite hospital staff, work accounts yourself when needed, and be the deepest Oracle Health (Cerner) and SSI Group user on the engagement. You will also build and document standard operating procedures, train the hospital’s permanent staff, and prepare the department for handoff back to the hospital at the end of the engagement. Critical access hospital experience is required. Experience with Cerner and SSI is highly preferred.

Reports to: Covered RCM Services Director

Schedule: Full-time, remote, aligned to Mountain Time business hours, with onsite time in Kanab, Utah approximately one week per month and during training and transition periods.

Key Responsibilities

Daily Operations Leadership

• Assign and monitor daily work across claim queues, edits and rejections, denials, AR follow-up, and patient accounts for Covered and hospital staff.
• Run the daily team huddle and the weekly check-in with the hospital CFO; maintain the open items list and escalate barriers to the Covered engagement lead.
• Serve as the day-to-day operational contact for hospital leadership, clinical departments, registration, and HIM on revenue cycle matters.
• Ensure claims transmit timely and accurately through SSI. Own the transition of remaining paper payers to electronic 837/835 transactions, including payer enrollment tracking.

Denials, AR, and Cash

• Oversee denial management and appeals; track denials by category and root cause, then drive corrective action with registration, coding, and clinical departments.
• Direct aged AR work with priority on accounts over 90, 180, and 365 days, high-dollar balances, and government payers. Review underpayments and payment variances against contract terms and the hospital’s cost-based interim rate.
• Oversee daily cash posting and reconciliation to deposits, credit balance review and refunds, and the quarterly Medicare credit balance report.
• Oversee patient statements, payment plans, financial assistance screening, and bad debt and collection agency placement and recall. Maintain the Medicare bad debt log in support of the cost report.

Reporting and Performance

• Produce the monthly operational report to the hospital: claims submitted, corrected and rebilled, denials resolved, appeals submitted, AR accounts worked, cash collected, bad debt reviewed, agency recommendations, and staff trained.
• Track clean claim rate, denial rate, AR days, aging over 90 and 180 days, cash versus baseline, and productivity by team member. Present results monthly to the CFO and the Covered engagement lead.
• Set and enforce productivity, quality, and documentation standards for the team.

Training, SOPs, and Transition

• Write and maintain standard operating procedures and job aids for claim submission, edits and rejections, denials and appeals, AR follow-up, patient collections, cash posting, and bad debt review.
• Assess competency of current hospital staff, train new community hires, and provide one-on-one coaching. Validate competency before shifting account ownership to hospital staff.
• Support the hospital in defining roles, interviewing, and onboarding community-hired revenue cycle staff.
• Prepare the department for handoff with staffing recommendations, workflow improvement recommendations, and the outstanding opportunity report.

Expectations

• Maintain HIPAA compliance and follow hospital policies and procedures at all times.
• Ensure every team member documents all account activity contemporaneously and completely in the patient accounting system.
• Meet engagement deliverable deadlines and the performance standards established during onboarding.
• Communicate barriers, risks, and client concerns promptly to the Covered engagement lead.

Qualifications

• 7 years of hospital accounts receivable, billing, or revenue cycle experience, including 3 years in a critical access hospital.
• 3 years supervising or leading a hospital business office or revenue cycle team, including setting productivity standards and coaching staff.
• Working knowledge of UB-04 and CMS-1500 claim requirements; Medicare, Medicaid, and commercial payer rules; and CAH reimbursement, including swing bed and rural health clinic billing.
• Demonstrated experience reducing aged AR, lowering denials, or clearing a claims backlog, with results you can describe.
• Hands-on experience with Oracle Health (Cerner) Revenue Cycle and SSI Group highly preferred.
• Experience writing standard operating procedures and training staff on them.
• Strong Excel skills for AR analysis, trending, and monthly reporting.
• Clear written and verbal communication, including presenting to hospital executives and working alongside clinical staff.
• Comfortable working independently in a remote setting and leading a team you do not sit with every day.
• Able to travel to Kanab, Utah as described above.

Preferred Skills

• Experience in an interim management, turnaround, or outsourced revenue cycle engagement.
• Experience transitioning a hospital from paper to electronic claims, or through a clearinghouse or system conversion.
• Medicare cost report, Medicare bad debt, and CMS-838 credit balance reporting experience.
• Utah Medicaid experience.
• CRCR, CHFP, CRCE, CPB, CPC, RHIT, or CCS certification.

Requirements

• Federal exclusion screening against the OIG List of Excluded Individuals and Entities and SAM.gov, verified at hire and monitored monthly throughout employment.
• State Medicaid exclusion screening for the state of residence and Utah, verified at hire and monitored monthly throughout employment.
• Criminal background check covering seven years of county, state, and federal records, plus a national sex offender registry search.
• Social Security trace and Form I-9 employment eligibility verification.
• Employment history verification, three reference checks including two former direct supervisors, and verification of any coding or revenue cycle certification held.
• Signed confidentiality agreement and acceptable use acknowledgment.
• Valid driver’s license and ability to travel for onsite work.

Pay: $95,000.00 - $115,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Travel reimbursement
• Vision insurance

Application Question(s):

• What are your salary expectations for this role?
• Describe one revenue cycle problem you fixed as a leader: what the baseline was, what you did, and what the result was.
• How many people did you directly supervise in your most recent leadership role?

Experience:

• critical access hospital revenue cycle: 3 years (Required)
• revenue cycle supervision or management: 3 years (Required)
• Cerner: 2 years (Preferred)
• SSI: 2 years (Preferred)

Work Location: Hybrid remote in Kanab, UT 84741

Salary : $95,000 - $115,000