Revenue Cycle Manager

Overview

Under general supervision, the Revenue Cycle Manager is responsible for the day-to-day oversight and performance of LifeLinc's professional billing operations across multiple anesthesia facilities. This role ensures accuracy, efficiency, and compliance across all revenue cycle functions, including billing, claims management, denials, and collections.

The Revenue Cycle Manager is accountable for driving measurable improvements in reimbursement, operational efficiency, and revenue cycle performance through process optimization, team leadership, and data-driven decision-making.

Responsibilities

Revenue Cycle Operations

• Oversee daily billing operations, including claims submission, follow-up, denials, and appeals

• Ensure accurate and timely entry of demographic and billing information

• Monitor workflows for claims processing, account follow-up, and adjustments

• Serve as escalation point for complex billing, payer, and patient issues

Team Leadership

• Supervise revenue cycle team leads and staff

• Manage staffing levels, productivity, and workload distribution

• Conduct hiring, onboarding, and ongoing staff training

• Provide performance feedback and coaching to team members

• Manage timekeeping and payroll processes for direct reports

Process Improvement

• Develop and maintain SOPs across revenue cycle functions

• Identify inefficiencies and implement workflow improvements

• Automate processes and reporting where possible

• Partner with leadership to improve revenue capture and reduce denials

Compliance & Payer Management

• Ensure compliance with CMS and commercial payer guidelines

• Collaborate with coding leadership to ensure proper claims submission

• Monitor adherence to documentation and billing requirements

• Support audit readiness and compliance initiatives

Reporting & Analytics

• Analyze billing and revenue cycle data across multiple practices

• Produce monthly dashboards, reports, and performance summaries

• Identify trends, risks, and opportunities

• Generate ad hoc reporting for leadership

New Site Implementation

• Support onboarding of new facilities

• Establish billing workflows, staffing plans, and data integration processes

• Serve as billing point of contact for new sites

Performance Metrics (KPIs)

The Revenue Cycle Manager will be evaluated based on the following key performance indicators:

Financial Performance

• Net Collection Rate (NCR): Target ≥ 95-98%

• Gross Collection Rate (GCR): Target ≥ 35-45% (payer mix dependent)

• Denial Rate: Target ≤ 5-7% of total claims

• Appeal Success Rate: Target ≥ 60-75%

Accounts Receivable (AR) Management

• Days in AR: Target ≤ 35-45 days

• % AR > 90 Days: Target ≤ 15-20%

• AR Aging Distribution: Maintain healthy spread across aging buckets

• Timely Filing Compliance: ≥ 98% within payer limits

Operational Efficiency

• Clean Claim Rate (First Pass Acceptance): ≥ 95%

• Charge Lag (DOS to Bill): ≤ 3-5 days

• Denial Resolution Time: ≤ 15-25 days average

• Productivity per FTE: Defined by accounts worked / claims processed

Quality & Compliance

• Audit Accuracy (Coding/Billing): ≥ 95% accuracy

• Documentation Compliance: 100% adherence to payer requirements

• Error Rate in Demographics/Data Entry: ≤ 2-3%

• Zero tolerance for compliance violations

Reporting & Analytics

• Timely delivery of monthly reports and dashboards (100% on schedule)

• Identification and escalation of adverse trends within reporting cycle

• Implementation of data-driven improvement initiatives

Team Performance

• Employee Productivity Targets: Met or exceeded monthly

• Training Completion Rate: 100% for team members

• Employee Retention: Maintain stable staffing levels

• Engagement & Performance Reviews: Completed on schedule

Strategic Improvement

• Demonstrated reduction in denial rates over time

• Measurable improvement in AR and cash collections

• Successful implementation of process automation initiatives

• Contribution to new site onboarding success

Qualifications

Qualifications

Education

• Bachelor's degree in Healthcare Administration, Business, or related field preferred

Experience

• 5+ years in healthcare revenue cycle management

• Experience in anesthesia billing or CBO environment preferred

• CPC preferred or equivalent experience

Technical Skills

• Strong knowledge of:

o CPT & ICD-10 coding

o CMS and payer guidelines

o Revenue cycle workflows

• Proficiency in billing systems and Microsoft Office (Excel required)

Core Competencies

• Leadership and team development

• Analytical and problem-solving skills

• Attention to detail and accuracy

• Communication and interpersonal effectiveness

• Time management and organizational skills

• Customer service orientation