Manager of Revenue Cycle - Community Health Center

Manager of Revenue Cycle

Manhattan, NY · Full time, on site

About the role

We are a highly regarded Manhattan Federally Qualified Health Center (FQHC). As Manager of Revenue Cycle, you'll run billing from start to finish: registration, charge capture, coding, claims, payment posting, denials and collections. You'll lead a team of four and work in eClinicalWorks (eCW) every day. You'll also be the person leadership asks when they want to know why reimbursement is up or down.

The right person knows how FQHC billing actually works: Medicare FQHC PPS, Medicaid PPS and managed care wraparound, the sliding fee scale, and the claim formats each payer requires. You also want to coach your team and fix broken processes, not just keep them running.

What you'll do

• Lead and develop a team of four billing and revenue cycle staff. Set priorities, train, review work quality and run performance evaluations.
• Own the full revenue cycle in eCW: patient registration and eligibility, charge capture, claims submission, payment posting, denials and collections.
• Make sure claims are billed correctly for Medicare, Medicaid, Medicaid managed care and commercial payers, including FQHC PPS encounters and wraparound payments.
• Audit claims and provider documentation regularly. Find coding and documentation gaps, and work with providers and clinical leaders to fix them.
• Track and report on days in A/R, denial rate, clean claim rate, collections and payer mix. Find the root causes of problems and fix them.
• Keep the department ready for audits and compliant with Medicare, Medicaid and HRSA requirements, including the sliding fee discount program.
• Keep up with payer and regulatory changes, update workflows and train staff when rules change.

Required

• Experience managing a revenue cycle or billing team, ideally a small team of about 3 to 6 people.
• Hands-on experience with eClinicalWorks (eCW)
• Revenue cycle experience at an FQHC, community health center or similar outpatient setting.
• Working knowledge of Medicare and Medicaid billing rules, ICD-10 and CPT coding, and how commercial payers handle claims.
• Strong Excel skills for reporting and A/R analysis.

Strongly preferred

• Knowledge of Medicare reimbursement for FQHCs (PPS, G-codes, 837I/UB-04 claims).
• Claims and coding audit experience.
• Experience with HCFA (CMS-1500) claims.

Nice to have

• Coding background or credential (CPC, CCS or similar).
• Experience with NY Medicaid and Medicaid managed care plans.

Why this role

You'll manage a small team at a Manhattan community health center. The billing work you oversee directly funds care for patients who rely on it, and you'll have a direct line to leadership.