Patient Service and Revenue Manager - Carrell Clinic

Patient Service & Revenue Manager 
Reports to Chief Executive Officer 

Position Summary 

The Patient Service & Revenue Manager is responsible for leading all front-end revenue cycle operations within the 
orthopedic practice to ensure an exceptional patient experience while maximizing financial performance. This position 
oversees patient access processes including registration, insurance verification, referrals, authorizations, point-of-service 
collections, patient estimates, and front office workflows that directly impact clean claims and revenue capture. 
The manager serves as the primary liaison between the practice and the Revenue Cycle Management (RCM) department, 
ensuring operational alignment, resolving front-end billing issues, and providing onsite support to patients and staff 
regarding insurance and financial questions. 

Essential Responsibilities 
The essential duties of the position include the following. Other duties may be assigned. 

Patient Access Operations 
• Oversee daily operations of front office check-in and check-out processes.  
• Ensure accurate patient registration and demographic information.  
• Monitor workflows to improve efficiency, patient satisfaction, and revenue integrity.  
• Ensure timely and accurate collection of required documentation.  

Revenue Integrity 
• Ensure clean claim generation through accurate front-end processes.  
• Monitor registration accuracy, insurance verification, and documentation requirements.  
• Reduce claim denials related to registration, eligibility, authorizations, and referrals.  
• Partner with RCM to identify trends and implement corrective action plans.  

Insurance Verification, Referrals & Authorizations 
• Oversee insurance eligibility verification processes.  
• Ensure appropriate referrals and prior authorizations are obtained before services.  
• Supervise staff responsible for prior authorizations.  
• Serve as the subject matter expert for payer requirements and insurance-related questions.  

Patient Financial Services 
• Ensure accurate patient estimates are generated.  
• Oversee surgery estimates and collections.  
• Ensure appropriate time-of-service collections are obtained.  
• Assist patients with estimate questions and straightforward account balance inquiries.  
• Escalate complex billing concerns to Revenue Cycle when appropriate.  

Training & Staff Development 
• Train and mentor front office staff and management regarding:  
o Insurance coverage  
o Referral requirements  
o Prior authorizations  
o Patient estimates  
o Collection policies  
o Financial counseling basics  
o Registration accuracy  
• Develop standardized workflows and educational resources.  
• Monitor staff competency and provide ongoing coaching.  

Revenue Cycle Collaboration 
• Serve as the operational liaison between clinic leadership and the Revenue Cycle department.  
• Participate in revenue cycle meetings and initiatives.  
• Communicate payer changes and workflow updates to clinic staff.  
• Assist with implementation of new revenue cycle processes.  
• Help resolve front-end billing issues before they become claim denials.

 
Patient Experience 
• Provide onsite assistance for patients with:  
o Estimate questions  
o Insurance coverage questions  
o Time-of-service payment expectations  
o Basic account balance inquiries  
• Promote a positive financial experience through clear communication and compassionate service.  

Performance Monitoring 
• Monitor key performance indicators including:  
o Clean claim rate  
o Front-end denial trends  
o Point-of-service collection rates  
o Authorization completion  
o Estimate accuracy  
o Registration accuracy  
o Patient satisfaction related to access and financial services  

• Develop action plans to improve operational performance.  
 

Qualifications 

Education 
• Bachelor's degree in Healthcare Administration, Business Administration, or related field preferred.  
• Equivalent healthcare leadership experience may be considered.  

Experience 
• Five or more years of experience in physician practice operations, revenue cycle, patient access, or medical office 
  management.  
• Orthopedic practice experience preferred.  
• Supervisory or leadership experience preferred.  

Knowledge 
 Strong understanding of: 
• Medical insurance plans  
• Commercial and government payers  
• Prior authorizations  
• Referrals  
• Medical terminology  
• Patient financial counseling  
• Revenue cycle operations  
• Medical billing fundamentals  
• Point-of-service collections  
• Clean claim principles  
• Practice management systems and electronic health records  

Skills 
• Strong leadership and coaching abilities  
• Excellent customer service and communication skills  
• Ability to resolve patient concerns professionally  
• Strong analytical and problem-solving skills  
• Ability to collaborate across departments  
• Detail-oriented with excellent organizational skills  
• Ability to manage multiple priorities in a fast-paced clinical environment  

Success Measures 
Success in this position will be demonstrated by: 
• Improved clean claim rate  
• Reduced front-end claim denials  
• Increased point-of-service collections  
• Timely completion of authorizations and referrals  
• High patient satisfaction with financial communication  
• Well-trained, knowledgeable front office staff and management 
• Strong collaboration between clinic operations and Revenue Cycle  
• Consistent compliance with payer requirements and organizational policies