What are the responsibilities and job description for the Revenue Cycle Insurance Manager - Sign on Bonus $30,000.00 position at MDS (Medical Data Systems, Inc.)?
Position Summary
The Revenue Cycle Insurance Manager is a senior people leader responsible for driving hospital insurance collections performance through strong leadership, accountability, and payer strategy. This role owns the execution and outcomes of hospital insurance A/R and denials management, leading teams that resolve complex, high-dollar claims while ensuring compliance, consistency, and sustained cash flow. The ideal candidate is a decisive, visible leader who develops talent, enforces standards, and partners across departments to achieve measurable financial results.
Key ResponsibilitiesLeadership, Culture & Accountability (Primary Emphasis)
Required
The Revenue Cycle Insurance Manager is a senior people leader responsible for driving hospital insurance collections performance through strong leadership, accountability, and payer strategy. This role owns the execution and outcomes of hospital insurance A/R and denials management, leading teams that resolve complex, high-dollar claims while ensuring compliance, consistency, and sustained cash flow. The ideal candidate is a decisive, visible leader who develops talent, enforces standards, and partners across departments to achieve measurable financial results.
Key ResponsibilitiesLeadership, Culture & Accountability (Primary Emphasis)
- Lead, inspire, and develop hospital insurance A/R and denial management teams through clear expectations, coaching, and performance management.
- Build a high-accountability culture focused on results, quality, compliance, and continuous improvement.
- Establish clear roles, productivity standards, and quality benchmarks for managers, supervisors, and staff.
- Conduct regular performance reviews, corrective action, and succession planning for key revenue cycle roles.
- Serve as a trusted leader and subject matter authority for hospital insurance reimbursement and payer strategy.
- Own end-to-end performance of hospital insurance accounts receivable, with direct accountability for AR days, aging, and collections.
- Lead denial prevention, management, and appeals strategy across Medicare, Medicaid, commercial, managed care, and governmental payers.
- Direct resolution of high-risk, high-dollar, and complex hospital claims requiring escalation or negotiation.
- Identify payer trends and root causes impacting reimbursement and drive corrective action plans.
- Serve as the primary escalation point for payer disputes, underpayments, and systemic reimbursement issues.
- Lead payer strategy discussions and represent the organization in payer meetings and negotiations.
- Translate operational performance into executive-level insights, risks, and recommendations.
- Partner with Coding, CDI, Utilization Review, Case Management, Registration, Compliance, and IT leaders to improve insurance reimbursement outcomes.
- Lead cross-functional initiatives to reduce preventable denials and improve first-pass resolution.
- Influence stakeholders without direct authority to drive enterprise-wide revenue cycle improvement.
- Establish and monitor hospital insurance revenue cycle KPIs, including AR aging, denial rates, appeal success, and insurance cash.
- Hold leaders and teams accountable for meeting performance targets through data-driven action plans.
- Support budgeting, forecasting, and strategic planning related to hospital reimbursement and cash flow.
- Ensure insurance follow-up and appeals processes comply with CMS, payer contracts, and state and federal regulations.
- Maintain audit-ready documentation and lead teams through internal and external audits.
- Proactively identify compliance risks and implement corrective action plans.
- Provide leadership oversight for physician/professional insurance A/R to ensure alignment with hospital payer strategies.
- Monitor denial trends and payer behavior across professional billing to drive consistent enterprise standards.
Required
- Bachelor’s degree in healthcare administration, Business, Finance, or related field (or equivalent experience).
- 7 years of progressive revenue cycle experience with significant hospital insurance A/R leadership responsibility.
- Demonstrated success leading teams responsible for hospital collections, denials, and appeals.
- Strong working knowledge of hospital reimbursement methodologies and payer regulations.
- Proven people leader with the ability to motivate, develop, and retain high-performing teams
- Decisive, accountable, and results-driven leadership style
- Strong executive presence and communication skills
- Strategic thinker with the ability to translate data into action