Revenue Cycle Manager

WHO ARE WE?

The Wound Pros is the nation’s largest wound care management company, with a presence in 19 states and counting. Our mission is to facilitate the standardization of evaluating and treating chronic wounds in long-term care facilities by leveraging the power of AI and technology. We offer various essential services, including Digital Wound Management, Telemedicine, Advanced EHR Systems, Mobile Vascular Assessment, Digital Supply Tracking, Advanced Wound Care Dressings, and participation as a Medicare Part B provider.

Kickstart your career by joining a growing number of professionals committed to healing wounds and saving lives. At The Wound Pros, we live and breathe diversity. We pride ourselves in our team of passionate professionals from all over the world. Our core values are: we Listen, Innovate, Never give up, and ‘Kultivate’ & grow (LINK) people in their careers. 

JOB SUMMARY

The Revenue Cycle Manager is responsible for overseeing the billing and coding staff along with making day-to-day decisions; responsible for understanding and ensuring all procedures are coded within regulatory mandates; assists with following up on insurance claims, and submits appeals as needed. This position is responsible for directing and coordinating the overall functions of the billing and coding office to ensure maximization of cash flow while improving patient, physician, and other customer relations. The Revenue Cycle Manager position requires the ability to produce and present detailed billing activity reports.

WHAT ARE YOUR ASSIGNMENTS

• Oversees billing department functions, including medical coding, charge entry, claims submission, payment posting, accounts receivable follow-up, and reimbursement management.
• Serves as the practice expert and primary resource for all billing processes.
• Plans and directs patient insurance documentation, coding, billing, collections, and data processing to ensure accuracy and efficiency.
• Analyzes billing and claims for accuracy and completeness, submits claims to appropriate insurance entities, and follows up on any issues using practice management and clearinghouse systems.
• Maintains communication with other departments to gather additional patient information for accurate billing.
• Prepares and analyzes accounts receivable and financial reports in collaboration with the CFO, including generating accurate statistical reports.
• Conducts monthly analysis of payer trends (Medicare, Medicaid, and third-party payers) to optimize reimbursement processes.
• Ensures compliance with Federal, State, and payer regulations, guidelines, and requirements in all billing operations.
• Manages and updates the charge master according to CMS fee schedules and negotiated contracts.
• Oversees the processing of credentialing and provider enrollment applications for Medicaid, Medicare, and commercial payers, including re-enrollment.
• Develops, implements, and audits billing policies and procedures to improve efficiency and ensure compliance.
• Tracks and adapts to carrier rule changes and distributes updates to the practice.
• Review operational data to assess and implement procedural revisions for revenue and operational improvements in coordination with the CFO.
• Supervises billing office personnel, managing work allocation, training, and addressing staff needs to ensure peak performance.
• Provides ongoing training for billing staff on policies, protocols, systems, and compliance requirements.
• Coordinates team member scheduling to maintain necessary daily functions.
• Maintains documentation tools, coding guidelines, and compliance resources for the team.
• Performs all duties in an efficient, collaborative, and team-oriented manner.

WHAT YOU HAVE ALREADY ACHIEVED

• Strong knowledge of healthcare financial management and medical billing processes.
• Exceptional analytical and problem-solving skills with a strong attention to detail.
• Proficient in using healthcare billing software and revenue cycle management tools.
• Strong leadership skills with the ability to manage and motivate a team.
• Excellent communication and interpersonal skills with the ability to interact effectively with all levels of the organization.
• Strong knowledge of federal, state, and payer-specific regulations and policies.
• Ability to work in a fast-paced environment and manage multiple priorities.

ATTRIBUTES NEEDED FOR THE ROLE

• Associate degree, preferably in business administration or related field; Bachelor's degree preferred. 
• 7 years of medical insurance/healthcare revenue cycle experience will be considered in lieu of the degree.
• Medical coding certification is required.
• Minimum of 3 years of medical insurance/healthcare billing and collections experience in a medical practice or health system, with a deep understanding of medical billing rules and regulations. Wound Care is preferred.
• Two years of supervisory or management experience is preferred.

EQUAL OPPORTUNITY EMPLOYER

The Wound Pros is an equal opportunity employer committed to being an employer of choice, not just an excellent place to work but a great and inclusive place to work. We strive to recruit and maintain a diverse workforce. Qualified applicants will receive consideration for employment without regard to race, physical or mental disability, color, religious creed, ancestry, national origin, religion, age, sex, marital status, genetic information or testing, gender identity and expression, sexual orientation or status as a Vietnam-era or special disabled veteran or any characteristic protected by law.