Revenue Cycle Insurance Manager

Company : Medical Data Systems

Job Type : Full Time

Sebring, Fl

Number of Applicants

000+

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Job Description - Revenue Cycle Insurance Manager

Position Summary
The Revenue Cycle Insurance Manager is a senior people leader responsible for driving hospital insurance collections performance through strong leadership, accountability, and payer strategy. This role owns the execution and outcomes of hospital insurance A/R and denials management, leading teams that resolve complex, high-dollar claims while ensuring compliance, consistency, and sustained cash flow. The ideal candidate is a decisive, visible leader who develops talent, enforces standards, and partners across departments to achieve measurable financial results.
Key Responsibilities

Leadership, Culture & Accountability (Primary Emphasis)

Lead, inspire, and develop hospital insurance A/R and denial management teams through clear expectations, coaching, and performance management.
Build a high-accountability culture focused on results, quality, compliance, and continuous improvement.
Establish clear roles, productivity standards, and quality benchmarks for managers, supervisors, and staff.
Conduct regular performance reviews, corrective action, and succession planning for key revenue cycle roles.
Serve as a trusted leader and subject matter authority for hospital insurance reimbursement and payer strategy.

Hospital Insurance A/R & Denials Strategy

Own end-to-end performance of hospital insurance accounts receivable, with direct accountability for AR days, aging, and collections.
Lead denial prevention, management, and appeals strategy across Medicare, Medicaid, commercial, managed care, and governmental payers.
Direct resolution of high-risk, high-dollar, and complex hospital claims requiring escalation or negotiation.
Identify payer trends and root causes impacting reimbursement and drive corrective action plans.

Payer Relations & Executive Communication

Serve as the primary escalation point for payer disputes, underpayments, and systemic reimbursement issues.
Lead payer strategy discussions and represent the organization in payer meetings and negotiations.
Translate operational performance into executive-level insights, risks, and recommendations.

Cross-Functional Leadership & Collaboration

Partner with Coding, CDI, Utilization Review, Case Management, Registration, Compliance, and IT leaders to improve insurance reimbursement outcomes.
Lead cross-functional initiatives to reduce preventable denials and improve first-pass resolution.
Influence stakeholders without direct authority to drive enterprise-wide revenue cycle improvement.

Financial Performance & Reporting

Establish and monitor hospital insurance revenue cycle KPIs, including AR aging, denial rates, appeal success, and insurance cash.
Hold leaders and teams accountable for meeting performance targets through data-driven action plans.
Support budgeting, forecasting, and strategic planning related to hospital reimbursement and cash flow.

Compliance, Risk & Audit Oversight

Ensure insurance follow-up and appeals processes comply with CMS, payer contracts, and state and federal regulations.
Maintain audit-ready documentation and lead teams through internal and external audits.
Proactively identify compliance risks and implement corrective action plans.

Physician Billing Insurance Oversight (Secondary)

Provide leadership oversight for physician/professional insurance A/R to ensure alignment with hospital payer strategies.
Monitor denial trends and payer behavior across professional billing to drive consistent enterprise standards.

Qualifications

Bachelor’s degree in healthcare administration, Business, Finance, or related field (or equivalent experience).
7+ years of progressive revenue cycle experience with significant hospital insurance A/R leadership responsibility.
Demonstrated success leading teams responsible for hospital collections, denials, and appeals.
Strong working knowledge of hospital reimbursement methodologies and payer regulations.

Leadership Competencies

Proven people leader with the ability to motivate, develop, and retain high-performing teams
Decisive, accountable, and results-driven leadership style
Strong executive presence and communication skills
Strategic thinker with the ability to translate data into action

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Revenue Cycle Insurance Manager

Job Description - Revenue Cycle Insurance Manager

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