Senior Revenue Cycle and Claims Project Manager

Job Description

Job Description

Description:

At e4health, we Empower Better Health . The e4health Team is on a relentless mission to care for those teams who care for others. We bring our passion, ingenuity, and expertise to every engagement. In joining our Team, we want your help to provide our customers with powerful solutions in the pursuit of quality, integrity, clinical and financial value across healthcare.

Our People make the difference. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. e4health solutions streamline clinical, financial, and health information data and workflows, optimize coding, quality, and clinical documentation integrity processes, and address health IT operational challenges to deliver material results for healthcare organizations across the country. Learn more about us at

The Financial and Claims Reporting Analyst is responsible for designing, developing, and maintaining financial and claims reports that support business operations, regulatory compliance, and strategic decision-making. This role partners with Finance, Claims, Operations, and IT teams to transform complex data into accurate, meaningful, and user-friendly reports. The ideal candidate has strong report-writing experience, excellent analytical skills, and the ability to automate reporting processes while ensuring data integrity.

Job Summary

The Senior Revenue Cycle and Claims Project Manager is responsible for leading strategic projects that improve revenue cycle performance, claims management, accounts receivable, reimbursement processes, and operational efficiency across healthcare organizations. This role partners with clinical, financial, IT, compliance, and payer stakeholders to implement process improvements, optimize revenue cycle technology, ensure regulatory compliance, and maximize reimbursement while minimizing claim denials and payment delays.

Key Responsibilities

· Lead complex revenue cycle and claims management projects from planning through implementation and post-go-live support.

· Develop project plans, timelines, budgets, resource allocations, and risk mitigation strategies.

· Analyze revenue cycle workflows, identify operational gaps, and implement process improvements.

· Collaborate with billing, coding, patient access, HIM, finance, compliance, and IT departments to improve financial performance.

· Monitor key performance indicators (KPIs), including:

· Clean claim rate

· Days in Accounts Receivable (A/R)

· Denial rate

· First-pass resolution rate

· Net collection rate

· Cash collections

· Oversee balancing of A/R for organizations

· Oversee claims denial management initiatives and root cause analysis.

· Coordinate payer contract implementation and reimbursement optimization projects.

· Support system implementations, upgrades, and integrations involving Electronic Health Records (EHR), Practice Management Systems (PMS), and claims clearinghouses.

· Ensure compliance with CMS regulations, HIPAA requirements, payer policies, and industry standards.

· Facilitate project meetings, provide executive status reports, and communicate project milestones to stakeholders.

· Develop policies, standard operating procedures, and training materials.

· Mentor project team members and provide leadership across cross-functional initiatives.

· Manage vendor relationships and coordinate external consulting resources when necessary.

· Support audits and regulatory reviews related to revenue cycle operations.

Required Qualifications

· Bachelor's degree in Healthcare Administration, Business Administration, Finance, Health Information Management, or a related field.

· 7–10+ years of progressive experience in revenue cycle management, claims administration, and accounts receivable balancing and management.

· 5+ years of project management experience leading enterprise-level initiatives.

· Strong knowledge of:

· Medical billing and coding

· Claims adjudication

· Accounts receivable processing and balancing

· Revenue cycle operations

· Medicare, Medicaid, and commercial payer regulations

· Revenue integrity

· Denial management

· Experience with EHR and practice management systems (e.g., Epic, Cerner, Meditech, Athenahealth).

· Proficiency with Microsoft Office Suite, particularly Excel, PowerPoint, and Project.

· Strong analytical, organizational, communication, and leadership skills.

Preferred Qualifications

· Master's degree (MBA, MHA, MPH, or related field).

· Project Management Professional (PMP) certification.

· Athena experience is preferred but not required

· Certified Revenue Cycle Representative (CRCR).

· Certified Healthcare Financial Professional (CHFP).

· Lean Six Sigma Green Belt or Black Belt certification.

· Experience with healthcare analytics and business intelligence tools (e.g., Tableau, Power BI).

Additional information:

401(k) ELIGIBILITY e4health offers a retirement benefits package including 401(k) with company match.

• Full-time employees will be eligible to contribute to a 401(k)-retirement account after successfully completing 90 days of employment.

• Part-time employees will be eligible to contribute to a 401(k)-retirement account after completing 250 hours of worktime.

The items listed below pertain to Full-Time Employees/Consultants only

BENEFITS :

We offer an excellent salary, full benefits package including 401(k) with company match, medical, dental, vision, life, short/long term disability insurance, and PTO policy.

PHYSICAL DEMANDS OF THE ESSENTIAL FUNCTIONS:

Sitting, talking, hearing and near vision are required over 90% of the time. Feeling is required over 90% of the time and reaching is required about 50% of the time. The ability to travel to field sites may be required up to 15% of the time.

WORKING CONDITIONS WHILE PERFORMING ESSENTIAL FUNCTIONS:

Over 90% of the time is spent indoors, with protection from weather conditions. Exposure to noise levels that may be distracting or uncomfortable is present in only unusual situations.

e4health is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

At our organization, we believe in the principles of pay transparency to foster a fair and equitable workplace for all employees. In alignment with this commitment, we openly communicate salary ranges, bonus structures, and additional financial benefits associated with each position. We believe that transparency in compensation not only promotes trust and accountability but also helps mitigate wage gaps and biases. By providing clear and comprehensive information about compensation in our job descriptions, we aim to create a transparent and inclusive environment where all employees feel valued and respected. Join us in building a culture of fairness and transparency as we strive for excellence together.