Manager of Revenue Cycle

Job Description The Revenue Cycle Manager is responsible for the strategic oversight and day-to-day management of the hospital’s financial health. This role leads the Billing and Coding teams in a specialized pediatric environment, ensuring high-quality charge capture, accurate coding, and timely reimbursement. A critical component of this role includes leading the department through a transition from legacy systems (Meditech and Athena) to an Epic platform, while maintaining expert compliance with Illinois Medicaid regulations and pediatric-specific billing requirements. Key Responsibilities Leadership & Supervision Direct Supervision: Manage, mentor, and evaluate the performance of Billing and Coding specialists. Staff Development: Provide continuous training on pediatric-specific coding (ICD-10-CM, CPT, HCPCS) and evolving payer regulations. Workflow Optimization: Establish departmental KPIs (Days in AR, Clean Claim Rate, Denial Rate) and hold staff accountable to production standards. Systems & Implementation Legacy Management: Oversee current revenue operations within Meditech (Hospital/Inpatient) and Athena (Ambulatory/Outpatient) to ensure no revenue leakage during the transition. Epic Implementation: Serve as the Revenue Cycle Subject Matter Expert (SME) for the Epic go-live. Duties include workflow design, system testing, data migration validation, and end-user training for the billing/coding modules. Interoperability: Ensure seamless data flow between legacy archives and the new Epic environment. Illinois Medicaid & Pediatric Compliance Regulatory Expertise: Serve as the primary resource for Illinois Medicaid (HFS) guidelines, including Managed Care Organizations (MCOs) and the All Kids program. Pediatric Billing: Manage complex pediatric billing scenarios, including neonatal care, rehabilitative therapy, and long-term pediatric chronic care. Audit & Compliance: Conduct internal audits to ensure coding accuracy and compliance with state and federal healthcare laws. Financial Operations Denial Management: Analyze denial trends and implement root-cause solutions to reduce rejections from Illinois Medicaid and commercial payers. Reporting: Prepare monthly financial reports and dashboards for senior leadership regarding AR aging and cash collection targets. Liaison: Act as the bridge between clinical departments and the finance office to ensure clinical documentation supports billed services. Qualifications Education: Bachelor’s degree in Healthcare Administration, Finance, or a related field (Master’s preferred). Experience: Minimum 5+ years in Healthcare Revenue Cycle Management; supervisory role overseeing billing and coding professionals; direct experience with Illinois Medicaid reimbursement and policy. Technical Skills: Proficiency in Meditech and AthenaIDX/One; Epic Certification or previous experience leading an Epic Implementation (Resolute Hospital Billing/Professional Billing) is highly preferred. Certifications: CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or CRCR (Certified Revenue Cycle Representative) preferred. Required Competencies Change Management: Ability to lead a team through the technical and emotional challenges of a major EHR transition. Analytical Thinking: Deep understanding of healthcare data to identify trends in underpayments or billing errors. Pediatric Focus: Sensitivity to the unique billing needs of a small, 39-bed children’s facility. Additional Information La Rabida Children’s Hospital is very proud to be an Equal Employment Opportunity Employer. Compensation $80,000-$80,000 per year #J-18808-Ljbffr La Rabida Children's Hospital