Revenue Cycle Manager

Revenue Cycle Manager

Are you a Revenue Cycle Professional seeking an exciting new career opportunity? Look no further! Tutera Senior Living & Health Care is seeking rockstars to join our team! If you are dedicated and compassionate, WE WANT YOU!

The Revenue Cycle Manager is responsible for the day-to-day leadership and operational oversight of the Central Billing Office supporting a multi-state portfolio of Skilled Nursing Facilities and Senior Living Medicaid Waiver communities.

This position requires expert-level knowledge of Skilled Nursing Facility claims and reimbursement. The Revenue Cycle Manager must be able to independently review and troubleshoot complex SNF claims, understand how information from facility operations and PointClickCare (PCC) ultimately impacts the claim, identify billing and reimbursement errors, interpret payer and contract requirements, and provide expert guidance to billing and denial resolution staff.

The Revenue Cycle Manager oversees a remote Central Billing Office team of approximately 25 employees, including billers, team leads, and denial resolution staff. The team currently supports 45+ Skilled Nursing Facilities and 5 Senior Living Medicaid Waiver communities, with the expectation that the portfolio may increase rapidly.

In addition to managing daily billing operations, this position serves as a primary Revenue Cycle resource for complex payer and claim issues, denial escalation, Triple Check accuracy, facility education, revenue and cash trend analysis, and communication of reimbursement risks and cash delays to Revenue Cycle and senior leadership.

The successful candidate must combine deep SNF claims expertise with strong leadership, analytical ability, attention to detail, sound judgment, and the ability to operate effectively in a fast-paced, high-pressure environment.

Do You Have What It Takes?

• Central Billing Office Leadership
  • Provide day-to-day leadership and operational oversight of a remote Central Billing Office team of approximately 25 employees, including billers, team leads, and denial resolution staff.
  • Oversee billing operations for 45+ Skilled Nursing Facilities and 5 Senior Living Medicaid Waiver communities across multiple states.
  • Establish and maintain expectations for billing accuracy, timeliness, productivity, account follow-up, documentation, and accountability.
  • Ensure claims are billed accurately and timely and that unresolved billing issues are appropriately prioritized and escalated.
  • Monitor team workloads, performance, and productivity across a large and changing facility portfolio.
  • Partner with team leads to identify performance concerns, knowledge gaps, and training needs.
  • Provide coaching, education, and technical support to billing and denial resolution staff.
  • Assist with hiring, onboarding, training, and development of Central Billing Office employees.
  • Ensure adequate team coverage and appropriate distribution of responsibilities as the organization grows or facility assignments change.
  • Create a collaborative environment while maintaining clear accountability for Revenue Cycle expectations and results.
• SNF Claims & Billing Expertise
  • Serve as a subject-matter expert for Skilled Nursing Facility claims and reimbursement.
  • Independently review complex SNF claims and identify errors affecting billing, reimbursement, or payment.
  • Maintain expert knowledge of Medicare, Medicaid, Medicare Advantage/Managed Care, Medicaid Managed Care, commercial insurance, and other payer billing requirements applicable to Skilled Nursing Facilities.
  • Understand how information throughout the resident and Revenue Cycle process ultimately impacts the claim, including:
  • Census and payer information
  • Medicare eligibility and benefit periods
  • Qualifying Hospital Stay requirements
  • Authorizations
  • MDS and PDPM/HIPPS information
  • Clinical documentation
  • Rates and reimbursement methodology
  • Therapy and ancillary services
  • Coinsurance
  • Payer and contract requirements
  • Consolidated billing requirements
  • Claim adjustments and corrections
  • Understand the complete lifecycle of a SNF claim from admission and payer verification through claim creation, submission, adjudication, payment, denial, adjustment, and final resolution.
  • Identify upstream errors that may result in incorrect claims, denials, underpayments, delayed reimbursement, or revenue loss.
  • Provide technical guidance when billing staff encounter unusual or complex claim situations.
  • Maintain knowledge of changing payer and regulatory requirements affecting SNF billing.
• Denial Management & Complex Claim Resolution
  • Serve as a primary escalation resource for claims that cannot be resolved through normal billing or denial resolution processes.
  • Assist denial resolution staff with complex Medicare, Medicaid, Managed Care, and commercial insurance denials.
  • Review denied, rejected, underpaid, or delayed claims to determine the underlying cause.
  • Ensure the team is identifying root cause rather than simply correcting individual claims.
  • Analyze denial trends to identify recurring issues by payer, facility, claim type, or operational process.
  • Determine whether recurring issues originate from billing, payer setup, authorization, census, MDS/clinical information, contract configuration, facility processes, payer processing, or another source.
  • Work with appropriate internal departments and payer representatives to resolve systemic reimbursement issues.
  • Identify opportunities for education or process correction when preventable denials are recurring.
  • Monitor high-value or high-risk claim issues through resolution.
• Payer & Contract Support
  • Maintain a strong working understanding of payer contracts as they relate to billing and reimbursement.
  • Interpret reimbursement methodologies, authorization requirements, covered services, exclusions, carve-outs, filing requirements, rates, and other contractual provisions affecting claims.
  • Assist the billing team in determining how contract terms should be reflected in claim submission and expected reimbursement.
  • Identify discrepancies between contract terms, payer setup, system configuration, claims, and actual reimbursement.
  • Assist with payer issues that are delaying or negatively affecting reimbursement.
  • Partner with Payer Relations, contracting, credentialing, and other Revenue Cycle functions when issues extend beyond normal billing resolution.
  • Escalate significant payer or contractual concerns that may create material cash delays or revenue leakage.
• Triple Check & Claim Accuracy
  • Participate in and provide leadership support for the Triple Check process.
  • Train facility Business Office Managers and other applicable facility staff on Triple Check expectations and claim accuracy.
  • Ensure teams understand how information entered throughout the resident stay ultimately affects the final SNF claim.
  • Assist facilities with identifying discrepancies prior to claim submission whenever possible.
  • Review claim components and supporting information for consistency and accuracy.
  • Identify recurring Triple Check findings and determine whether additional facility or CBO education is needed.
  • Provide education regarding the financial impact of inaccurate census, payer, authorization, clinical, MDS, rate, or other information.
  • Work collaboratively with facility and corporate teams to reduce preventable billing errors before claims are submitted.
• Revenue, Cash & Trend Analysis
  • Monitor billing, revenue, cash collections, accounts receivable, denial activity, payer performance, and facility trends across the assigned portfolio.
  • Identify negative revenue and cash trends early and investigate the underlying cause.
  • Determine whether reimbursement delays are related to billing, payer processing, contract issues, facility execution, census or revenue changes, system configuration, authorization, clinical information, or other factors.
  • Analyze significant cash shortfalls and provide timely explanations of the underlying cause.
  • Identify potential revenue leakage or reimbursement risk and escalate material concerns.
  • Distinguish between expected timing differences and true Revenue Cycle performance issues.
  • Use data and claim-level analysis to validate conclusions rather than relying solely on anecdotal explanations.
• Senior Leadership Communication
  • Provide Revenue Cycle leadership with timely updates regarding significant billing, payer, denial, revenue, and cash issues.
  • Communicate material cash delays and their causes in real time when issues are identified.
  • Clearly explain what is causing a delay, the financial impact when known, actions underway, and any operational assistance needed.
  • Translate detailed billing and reimbursement information into concise explanations appropriate for senior and executive leadership.
  • Be prepared to answer questions regarding facility, payer,