Revenue Cycle Manager

Revenue Cycle Manager

The Revenue Cycle Manager (RCM Manager) will oversee all functions in the Billing/Accounts Receivable department and is responsible and accountable for the revenue cycle process, working collaboratively with front line staff, clinicians, department managers, and senior leadership to maximize revenue, provide reports demonstrating trends in patient accounts, and ensure accuracy and compliance in billing, collections, denials and ensure related financial screening areas (eg. Sliding fee discount policy, patient refunds, patient collections, COVID related claims, write offs).

General Accountabilities

• Oversee day-to-day revenue cycle operations, managing the full in-house billing lifecycle from charge capture through collections and reconciliation.
• Manage billing department staff (5) in daily activities, assign work, set completion dates, review work and manage performance in accordance with established policies and procedures.
• Supervise, hire, train, mentor, and evaluate billing and revenue cycle staff; manage workflow, productivity standards, and performance accountability.
• Establish and monitor productivity goals, AR benchmarks (including aging), and key financial metrics; remove barriers to optimize performance.
• Stay current with company's policies and procedures regarding AR activity such as, reviewing month end reports to guarantee the AR is below 20% over 90 days, identifying trends.
• Analyze denials, reimbursement trends, unbilled claims, credit balances, and AR variances; implement corrective action and oversee appeals and rebilling.
• Prompt response to requests for information, both internally and externally initiates and maintains direct contact with CHMB clients, engaged in proactive resolution of issues and timely response to questions and concerns.
• Ensure accurate charge entry, claim submission, payment posting, adjustments, and reconciliation within EHR and Practice Management systems.
• Monitor third-party billing, outsourced AR vendors, and payer/IPA portals to ensure accuracy, compliance, and optimal reimbursement.
• Maintain compliance with billing regulations, payer requirements, internal policies, and audit standards; support cost reports, UDS reporting, Medicare/Medi-Cal reconciliations, and audits.
• Delivers timely required reports to the Controller; initiates and communicates the resolution of issues, such as payer denial trends, collections accounts, inaccurate or incorrect charges, vendor input and implementation.
• Develop, implement, and improve revenue cycle workflows, SOPs, benchmarks (including FQHC standards), fee schedules, and billing policies.
• Prepare and present financial, operational, and AR performance reports to leadership, physicians, and stakeholders; assist with budgeting and forecasting.
• Serve as liaison to clients, patients, payers, and internal departments; resolve financial inquiries and AR issues with professionalism and timely follow-up.
• Partner with executive and operational leadership to ensure new programs and services are financially viable and billable.
• Conduct financial analysis, variance review, journal entry oversight, and month-end reporting related to revenue and receivables.
• Collaborate across departments to improve registration accuracy, billing workflows, and revenue cycle integrity.
• Document procedures, maintain transparency in reporting, and provide accurate, timely information to stakeholders.
• Perform additional duties and special projects as assigned to support organizational goals.

Requirements

Job Qualifications

• Degree in Finance or Accounting or a related field required.
• Bachelor in Finance, Accounting, Business, or Healthcare preferred.
• Five to seven (5-7) years of experience in billing, revenue cycle management required.
• Previous experience working in FQHC environment preferred.

Skills

• Takes ownership for delivering on commitments; owns mistakes and uses them as opportunities for learning and development; discusses openly his/her actions and their consequences both good and bad; has an ability to identify strengths and developmental opportunities and leverages insight in making adjustments to improve effectiveness; has the courage to engage in difficult conversation.
• Share information. Listens and involves others. Clearly conveys ideas in a manner that engages others and helps them understand and retain the message.
• Approaches problems and decisions methodically and objectively; involves others as needed; uses sound judgment in making decisions and understanding the impact to themselves, customers, their team, and the organization; conducts the appropriate analysis to identify the symptoms and root cause of issues; and makes timely decisions.
• Is focused on outcomes and accomplishments; follows through on commitments; can be counted upon to successfully execute on goals; motivated by achievement and a need for closure; has an attention to detail and is both efficient and effective in achieving a high level of measurable outcomes; persists in achieving goals despite obstacles.
• Speaks clearly and persuasively; Listens and gets clarification when necessary; Responds informatively to questions. Ability to be approachable by staff
• Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives.
• Approaches others in a polite and tactful manner; Maintains composure and reacts well under pressure; Treats others with respect and consideration; Accepts responsibility for own actions; Follows through on commitments.
• Demonstrates accuracy and thoroughness; Applies feedback to improve performance; Monitors own work to ensure quality.

Skills: Language

• Bilingual-English/Spanish preferred, not required.

Physical Requirement

• Physical effort which may include occasional light lifting to a 25 pound limit, and some bending, stooping or squatting. Considerable walking may be involved. The ability to sit or stand for extended periods of time is required.
• Flexibility to work in multiple locations throughout the week.
• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• While performing the duties of this job, the employee may be required to travel to all UCHC facilities as needed.
• Occasionally required to sit and walk.
• Finger dexterity required.
• Hand coordination required.
• Specific vision abilities required for this job include: close vision, distance vision, ability to adjust or focus.

Work Environment

• Exposure to adverse conditions.
• Exposure to extreme heat.
• Exposure to extreme cold.
• Exposure to wet and/or humid conditions.
• Exposure to moving mechanical parts.
• Exposure to high, precarious places.
• Exposure to fumes or airborne particles.
• Exposure to toxic or caustic chemicals.
• Exposure to outside weather conditions.
• Possible risk of electrical shock
• Exposure to explosives
• Possible risk of radiation and vibration.
• Protective clothing or equipment is required including: gloves, helmets, steel-toed boots, protective eyewear.
• The noise level in the work environment usually is high

Acknowledgement:

I understand that I may be asked to perform job-related duties not listed in the description and that my duties may change at any time, according to the UCHC needs. Nothing in this position description is intended