Revenue Cycle Manager

Job ID : Revenue Cycle Manager


Position Type: Full Time


Reports To: Chief Executive Officer (CEO)


Position Summary
The Revenue Cycle Manager is responsible for the overall management, optimization, and performance of the practice's revenue cycle operations from patient scheduling through final payment collection. This position oversees front-end and back-end revenue cycle functions, including insurance verification, authorization, charge capture, coding, billing, accounts receivable, payment posting, denials management, credentialing coordination, and patient collections. The Revenue Cycle Manager works collaboratively with physicians, clinical leadership, front office staff, and third-party payers to maximize reimbursement, ensure regulatory compliance, improve operational efficiencies, and enhance the patient financial experience.
Essential Duties and Responsibilities

Revenue Cycle Operations

• Oversee the complete revenue cycle from patient registration through final payment.
• Develop, implement, and monitor revenue cycle policies and procedures.
• Ensure accurate and timely billing of all physician and ancillary services.
• Monitor charge capture processes to ensure services are billed appropriately and promptly.
• Optimize reimbursement while maintaining compliance with payer and regulatory requirements.
• Identify opportunities to improve revenue, reduce denials, and streamline workflows.

Billing & Accounts Receivable

• Supervise billing staff responsible for claim submission, payment posting, and collections.
• Monitor Accounts Receivable (A/R) aging and establish goals for timely collections.
• Review payer trends and implement corrective action plans to reduce aging balances.
• Oversee denial management, appeals, and underpayment recovery efforts.
• Monitor collection rates, days in A/R, first-pass claim acceptance, clean claim rate, and bad debt.

Coding & Compliance

• Partner with certified coders to ensure accurate CPT, ICD-10, HCPCS, and modifier usage.
• Ensure compliance with CMS, Medicare, Medicaid, commercial payer, OSHA, HIPAA, and applicable federal and state regulations.
• Coordinate internal coding audits and corrective education.
• Stay current on payer policies, coding updates and reimbursement changes.

Financial Performance

• Prepare monthly revenue cycle reports and present key performance indicators to executive leadership.
• Analyze reimbursement trends by provider, location, payer, and service line.
• Develop action plans to improve financial performance and operational efficiencies.
• Assist with budgeting, forecasting, and revenue projections.

Leadership & Staff Development

• Directly supervise billing, collections, payment posting, insurance verification, and other revenue cycle personnel.
• Recruit, train, mentor, and evaluate staff performance.
• Establish productivity standards and accountability measures.
• Conduct regular team meetings and ongoing education.

Payer Relations

• Maintain positive working relationships with commercial insurance carriers, Medicare, Medicaid, workers' compensation carriers, and third-party administrators.
• Resolve escalated payer disputes and reimbursement issues.
• Assist leadership with payer contract implementation and operational impacts.

Cross-Department Collaboration

• Work closely with physicians, practice administrators, surgery scheduling, clinical staff, coding, and front office teams.
• Improve communication between departments to reduce billing errors and improve patient satisfaction.
• Support implementation of new services, providers, and technology affecting revenue cycle operations.

Qualifications

Education

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or related field preferred.
• Equivalent experience considered.

Experience

• Minimum of 5 years of progressive revenue cycle management experience.
• Minimum of 3 years in a leadership or management role.
• Experience within surgical, multispecialty, or physician practice strongly preferred.
• Experience managing high-volume physician billing operations.

Preferred Certifications

• Certified Revenue Cycle Representative (CRCR)
• Certified Professional Coder (CPC)
• Certified Professional Medical Auditor (CPMA)
• Certified Healthcare Financial Professional (HFMA)

Knowledge, Skills & Abilities

• Extensive knowledge of physician billing and reimbursement.
• Strong understanding of surgical coding and reimbursement.
• Detailed knowledge of Medicare, Medicaid, commercial insurance, workers' compensation, and personal injury billing.
• Experience with EHR and practice management systems.
• Advanced Microsoft Excel and reporting skills.
• Strong analytical and financial management abilities.
• Excellent leadership, communication, and organizational skills.
• Ability to manage multiple priorities in a fast-paced healthcare environment.
• Strong problem-solving and decision-making skills.
• High level of professionalism, integrity, and confidentiality.

Physical Requirements

• Prolonged periods of sitting and computer work.
• Occasional standing, walking, and lifting up to 20 pounds.
• Ability to communicate effectively in person, by telephone, and electronically.

Work Environment

• Professional medical office environment.
• Standard business hours with occasional extended hours as needed to meet operational demands.

Benefits

• Competitive salary
• Medical, Dental, and Vision Insurance
• Paid Time Off
• Paid Holidays
• 401(k) with employer match

This position plays a critical leadership role in maximizing the financial health of the practice while ensuring compliance, operational excellence, and an exceptional patient financial experience. The Revenue Cycle Manager is expected to foster a culture of accountability, continuous improvement, and collaboration across all revenue-generating functions of the organization.