Head of Business Operations - Remote

The Manager of Revenue Cycle Operations is responsible for overseeing operational performance across core revenue cycle functions to ensure accurate claim submission, compliant billing practices, timely reimbursement, and optimal financial performance.

This role provides leadership and oversight across middle-cycle and back-end revenue cycle operations including:

• Coding coordination
• Claim submission
• Billing
• Denial management
• Patient collections
• The Manager works collaboratively with clinical, operational, and finance leadership to improve reimbursement outcomes, operational efficiency, revenue capture, and overall financial performance.

50% Vendor Management

50% Internal Revenue Cycle Operations

Charge Entry & Coding Operations

• Ensure coding accuracy and compliance with payer requirements.
• Claim Submission & Billing
• Oversee claim preparation, claim scrubbing, and submission workflows.
• Ensure claims are submitted timely and accurately according to payer guidelines.
• Monitor claim edits and system workflows to support clean claim submission.
• Payment Posting & Reconciliation
• Ensure payment reconciliation accuracy.
• Accounts Receivable & Denial Management
• Manage insurance accounts receivable and denial resolution processes.
• Support timely follow-up on unpaid claims.
• Patient Financial Services
• Oversee patient balance collections and refund processes.
• Manage early-out vendors and bad debt placement processes.
• Ensure compliance with refund policies and patient financial regulations.
• Monitor charge capture accuracy and revenue reconciliation.
• Support revenue cycle performance monitoring and reporting.
• Accounts Receivable Vendor Management (50%)
• Serve as the primary point of contact and relationship manager for all outsourced Accounts Receivable vendors and business partners.
• Establish performance expectations, service level agreements (SLAs), and key performance indicators (KPIs) to ensure vendor accountability.
• Conduct regular vendor performance reviews focused on cash collections, aging reduction, denial resolution, productivity, quality, and turnaround times.
• Monitor and analyze AR vendor performance metrics, identifying trends, risks, and opportunities for improvement.
• Partner with vendors to develop and execute action plans to reduce aged AR, improve collection rates, and accelerate cash flow.
• Ensure compliance with organizational policies, payer requirements, contractual obligations, and regulatory standards.
• Facilitate ongoing communication between internal stakeholders and vendors to resolve operational issues and remove barriers to performance.
• Review and approve vendor invoices, evaluate return on investment, and recommend staffing or outsourcing adjustments as needed.
• Provide executive-level reporting and recommendations regarding vendor performance, AR trends, and revenue cycle optimization opportunities.
• Performance Accountability / Key Performance Indicators
• Staff Performance
• Quality assurance monitoring

Billing Performance

• Claim rejection and edit rate
• First-pass claim acceptance rate
• Claim submission timeliness
• Revenue Cycle Quality
• Duties may change at management’s discretion.

Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or a related field preferred.

• Experience with AthenaOne, NextGen, eClinicalWorks, or similar practice management systems preferred.
• Comprehensive knowledge of healthcare revenue cycle operations including patient access, charge capture, billing, payment posting, accounts receivable, and patient financial services.
• Knowledge of payer reimbursement methodologies including Medicare, Medicaid, and commercial insurance plans.
• Familiarity with CPT, HCPCS, and ICD-10 coding fundamentals and claim submission requirements.
• Understanding of point-of-service collections, patient financial counseling, and insurance benefit structures.
• Strong analytical skills with the ability to interpret revenue cycle performance metrics and operational data.
• Experience utilizing healthcare EMR and practice management systems (e.g., Knowledge of healthcare compliance requirements including HIPAA, documentation standards, and billing regulations.
• Type: Full-time, Remote position