Revenue Cycle Manager

Revenue Cycle Manager

The Revenue Cycle Manager is responsible for leading the daily operations of the complete healthcare revenue cycle, ensuring accurate billing, timely reimbursement, regulatory compliance, and optimized financial performance. This role serves as the primary daily operational leader responsible for front-end, mid-cycle, and back-end revenue cycle functions while driving process improvement, and team performance. The manager reports to the Director of Revenue Cycle and works collaboratively to evaluate department and organizational performance, evaluate optimizations, and translation of strategy into execution.

This is an ideal opportunity for an individual experienced in full revenue cycle operations for 10 or more physicians/APPs, has been responsible for the Revenue Cycle Management (RCM) functions, has leadership experience, and enjoys being close to the work: hands-on, coaching supervisors and staff, solving operational problems, and owning results.

Pay Range: $90,000 - $110,000/year (inclusive of 10% bonus based on performance)

Essential Duties and Responsibilities:

• Revenue Cycle Operations
• Oversee daily execution of the revenue cycle, including patient access, charge capture, coding, billing, accounts receivable, denials management, patient collections and release of information.
• Ensure clean claim submission, timely follow‑up, and optimal cash flow performance.
• Monitor workflow effectiveness and identify opportunities to streamline processes and reduce revenue leakage.
• Act as primary escalation point for daily revenue cycle operations support.
• Patient Access & Front-End Management
• Ensure accuracy of patient demographics, insurance verification, eligibility, prior authorizations, and point‑of‑service collections.
• Collaborate with front‑end teams to improve operations and reduce preventable denials.
• Coding, Compliance & Revenue Integrity
• Ensure coding processes are followed to ensure accuracy, completeness, and compliance with regulatory and payer requirements.
• Support clinical documentation improvement (CDI) initiatives in partnership with stakeholders.
• Ensure compliance with CMS, OIG, payer guidelines, and internal policies.
• Billing, Denials & Accounts Receivable Management
• Manage claim submission processes, edits, and work queues to maximize first‑pass yield.
• Analyze denial trends, identify root causes, and implement corrective action plans.
• Oversee insurance and self‑pay A/R follow‑up, underpayment recovery, and payer escalation strategies.
• Payer Performance & Reimbursement Optimization
• Monitor payer reimbursement accuracy against contract terms and fee schedules.
• Support payer contract modeling, variance analysis, and underpayment appeals.
• Partner with contracting and finance teams to improve net revenue performance.
• Financial Analytics & Reporting
• Track and report key revenue cycle KPIs, including days in A/R, denial rates, first‑pass yield, cash collections, and write‑offs.
• Prepare operational and financial reports for leadership and support data‑driven decision‑making.
• Benchmark performance against industry standards and organizational goals.
• Technology & Process Improvement
• Optimize processes and standard operating procedures to support best practices and standardization
• Participate in system upgrades, testing, and end‑user training initiatives.
• Leadership and Team Management
• Lead, coach, and develop revenue cycle staff to achieve operational and performance goals.
• Establish clear performance expectations and conduct regular evaluations.
• Foster collaboration across departments, including clinical operations, finance, compliance, and IT.
• Other duties as assigned.

Required Qualifications:

• Reside in San Diego County, California.
• High school diploma or equivalent required.
• Five (5) years of current/progressive, related experience leading & being responsible for the revenue cycle management for a practice of 10 or more physicians/APP's. OR a bachelor's degree in Business Administration, Healthcare Administration, or a related field plus three (3) years of current/progressive, related experience leading revenue cycle for a practice of 10 or more physicians/APP's.
• Three (3) years prior experience managing employees at different levels.
• Demonstrated hands-on experience and knowledge to successfully lead full revenue cycle operations.
• Strong demonstrated knowledge of medical billing, coding, claims, collections processes and strategy, reimbursement methodologies, and payer processes.
• Advanced analytical skills with the ability to interpret financial and operational data.
• Excellent communication, leadership, and problem-solving skills.

Preferred Qualifications:

• Seven (7) years of current experience leading & being responsible for revenue cycle management for a practice of 10 or more physicians/APP's.
• Bachelor's degree in Business Administration, Healthcare Administration, or related field.
• Professional certifications such as CRCR, CPC, CPB, or related Epic certifications in revenue cycle.
• Demonstrated, hands-on knowledge of Epic EHR revenue cycle functionality.
• Knowledge of value-based care, risk adjustment, and alternative payment models.

Other considerations:

• Background check required
• Travel to other sites located within San Diego County may be required
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
• Supervisory duties – Yes

This position is being handled internally. We are not accepting solicitations from external recruiters or staffing agencies at this time.

Language Skills

While performing duties, the employee is regularly required to talk, hear, read, write, type and respond in English and understand clinical/medical vocabulary written and spoken.

Vision Requirements

Vision requirements include close vision, ability to adjust focus, and see color.

Physical Demands

Physical requirements may vary slightly and should be reviewed with your manager. In general, this position requires the ability to lift up to 35 pounds unassisted; ability to stand for extended periods of time and to perform repetitive stooping, walking, stretching, reaching and some sitting; ability to use full range of body motions required to lift patients, wear a lead apron, and lift and move supplies. Must be able to safely ascend and descend stairs as a core part of the job, with or without reasonable accommodation, when no elevator or lift is present.

Work Environment

Job required tasks routinely involve a potential for mucous membrane or skin contact with blood, body fluids, tissues or potential spills or splashes. Use of appropriate personal protection measures is required for every healthcare provider in these positions. Require to routinely use standard office equipment such as laptop, computer, mouse, and photocopier.

About Balboa United

Beginning in 1973, Balboa has grown from two physicians to a comprehensive nephrology team of 52 board certified physicians and 8 advanced practitioners. On January 1, 2018, Balboa Nephrology Medical Group (BNMG) launched Balboa United, a full-service medical practice management services organization. From one small office, BNMG now has 24 clinical offices throughout San Diego, Imperial, Orange and Riverside counties. In addition to office and hospital-based patient care, Balboa physicians manage the dialysis treatments of approximately 4,500 patients at 88 dialysis centers and conduct Nephrology based clinical research at 6 centers throughout Imperial and San Diego counties (California Institute of Renal Research).

• EEO Statement Balboa United is an equal opportunity employer and makes employment decisions on the basis of merit. We want to have the best available person in every job. Our Company policy prohibits unlawful discrimination based on race, color, creed, religion (including religious dress & grooming), sex (including pregnancy, childbirth or related medical conditions), gender (including gender identity and gender expression), marital status, registered domestic partner status, military status, age, national origin or ancestry, physical or mental disability, medical condition (including