Revenue Cycle Manager

The Revenue Cycle Manager is responsible for overseeing all aspects of the revenue cycle for a Federally Qualified Health Center (FQHC), including patient registration, insurance verification, charge capture, coding, billing, collections, payment posting, accounts receivable management, and compliance with federal and state regulations. This position ensures timely and accurate reimbursement while supporting the organization's mission to provide accessible, high-quality healthcare services. About the Role The Revenue Cycle Manager works collaboratively with clinical, administrative, and finance teams to optimize revenue performance, improve operational efficiency, and maintain compliance with FQHC, HRSA, Medicare, Medicaid, and commercial payer requirements. Revenue Cycle Operations Manage the end-to-end revenue cycle process from patient registration through final payment collection. Oversee insurance verification, eligibility determination, prior authorizations, charge entry, coding, claims submission, payment posting, and collections. Monitor daily, weekly, and monthly revenue cycle activities to ensure timely reimbursement. Develop and implement workflows that improve revenue cycle efficiency and reduce denials. Ensure proper application of billing requirements, including Prospective Payment System (PPS) and applicable encounter billing guidelines. Accounts Receivable & Collections Monitor accounts receivable aging and establish performance goals for collection efforts. Analyze and resolve outstanding claims, denials, underpayments, and payment discrepancies. Develop action plans to reduce days in A/R and improve cash collections. Oversee patient payment plans and collection processes while maintaining a patient-centered approach. Ensure compliance with Medicare, Medicaid, HRSA, UDS reporting requirements, and commercial payer regulations. Collaborate with coding staff and providers to promote accurate documentation and coding practices. Conduct periodic audits of billing and coding processes to identify risks and opportunities for improvement. Stay current on regulatory changes affecting FQHC reimbursement and billing practices. Oversee provider payer enrollment, revalidation, and credentialing processes to support timely billing and reimbursement. Maintain accurate provider enrollment records and monitor credentialing timelines, expirations, payer approvals, and required updates. Coordinate with providers, leadership, payers, clearinghouses, and external credentialing resources to resolve enrollment issues and reimbursement delays. Ensure payer credentialing activities comply with Medicare, Medicaid, HRSA, commercial payer, and organizational requirements. Financial Performance & Reporting Prepare and analyze revenue cycle reports. Present revenue cycle performance metrics and recommendations to leadership. Assist with budgeting, forecasting, and revenue projections. Leadership & Staff Development Supervise and develop revenue cycle staff, including billing specialists, coders, payment posters, and patient financial services personnel. Establish performance expectations and provide ongoing coaching and training. Foster a culture of accountability, customer service, and continuous improvement. Participate in recruitment, onboarding, and performance management activities. Systems & Process Improvement Serve as a subject matter expert for practice management, electronic health record (EHR), and billing systems. Identify opportunities to automate processes and improve workflow efficiency. Partner with clinical and operational leaders to improve documentation, charge capture, and reimbursement outcomes. Manage outsourced vendor billing and coding partners, if applicable. Ensure compliance and service-level agreements are maintained. Perform other duties as assigned. Requirements and Skills Associate’s degree in a related field plus five years of relevant experience, or equivalent combination of education and experience. Proficient with MS Office, revenue cycle software systems, and EMR/ERH systems. Knowledge of HRSA compliance standards and Uniform Data System (UDS) reporting preferred. Prior experience in an FQHC community health care center, rural healthcare clinic, or other similar environment preferred. Certified Professional Coder (CPC), Certified Revenue Cycle Representative (CRCR), Certified Healthcare Financial Professional (CHFP), or other relevant healthcare revenue cycle certification strongly preferred. Experience with provider credentialing, payer enrollment, revalidation, and payer portal processes preferred. Strong mathematical, organizational, and analytical skills. Ability to successfully complete a pre-employment background check and drug screen. #J-18808-Ljbffr