Revenue Cycle Manager

Position Summary

The Revenue Cycle Manager works under the general supervision of the Chief Financial Officer and is responsible for overseeing the organization’s Revenue Cycle operations, including billing, collections, payment posting, denials and appeals, accounts receivable (A/R), revenue integrity, reconciliation, and related Revenue Cycle functions.

This position ensures that billing and payment processing are completed accurately and timely, with a focus on improving cash flow, reducing A/R and bad debt, preventing and resolving denials, and improving reimbursement. The Revenue Cycle Manager also coordinates Revenue Cycle activities across the organization and works with front desk, billing, collections, and other departments as needed.

The ideal candidate will have strong Revenue Cycle leadership experience, hands-on eClinicalWorks (eCW) expertise, strong financial and operational analysis skills, and the ability to identify and correct issues that affect reimbursement and overall Revenue Cycle performance.

Key Responsibilities

Revenue Cycle Management

• Direct the complete revenue cycle, including charge capture, claim submission, payment posting, collections, denials, appeals, and A/R management.
• Establish and monitor departmental KPIs for Billing, Collections, Payment Posting, Denials/Appeals, and other Revenue Cycle functions.
• Monitor A/R aging, collection rates, clean claim rates, denial rates, days in A/R, payment posting, and other performance indicators.
• Ensure claims are submitted accurately and timely and outstanding balances are appropriately worked.
• Develop and implement strategies to reduce A/R, improve cash collections, prevent avoidable denials, and maximize reimbursement.

Revenue Integrity & Compliance

• Ensure services are appropriately documented, coded, charged, and billed in accordance with payer requirements and applicable regulations.
• Monitor charge capture and coding processes to identify missed charges, coding issues, underpayments, and potential revenue leakage.
• Partner with Coding and clinical teams to address documentation and coding deficiencies.
• Maintain appropriate controls for contractual adjustments, write-offs, refunds, credit balances, and account corrections.
• Conduct periodic reviews and audits to identify Revenue Cycle integrity and compliance risks.

Denials & Reimbursement