Revenue Cycle Manager

Job ID: Revenue Cycle Manager 

Position Type: Full Time 

Reports To: Chief Executive Officer (CEO) 

Position Summary

Essential Duties and Responsibilities

Revenue Cycle Operations

• Oversee the complete revenue cycle from patient registration through final payment. 
• Develop, implement, and monitor revenue cycle policies and procedures. 
• Ensure accurate and timely billing of all physician and ancillary services. 
• Monitor charge capture processes to ensure services are billed appropriately and promptly. 
• Optimize reimbursement while maintaining compliance with payer and regulatory requirements. 
• Identify opportunities to improve revenue, reduce denials, and streamline workflows. 

Billing & Accounts Receivable

• Supervise billing staff responsible for claim submission, payment posting, and collections. 
• Monitor Accounts Receivable (A/R) aging and establish goals for timely collections. 
• Review payer trends and implement corrective action plans to reduce aging balances. 
• Oversee denial management, appeals, and underpayment recovery efforts. 
• Monitor collection rates, days in A/R, first-pass claim acceptance, clean claim rate, and bad debt. 

Coding & Compliance

• Partner with certified coders to ensure accurate CPT, ICD-10, HCPCS, and modifier usage. 
• Ensure compliance with CMS, Medicare, Medicaid, commercial payer, OSHA, HIPAA, and applicable federal and state regulations. 
• Coordinate internal coding audits and corrective education. 
• Stay current on payer policies, coding updates and reimbursement changes. 

Financial Performance

• Prepare monthly revenue cycle reports and present key performance indicators to executive leadership. 
• Analyze reimbursement trends by provider, location, payer, and service line. 
• Develop action plans to improve financial performance and operational efficiencies. 
• Assist with budgeting, forecasting, and revenue projections. 

Leadership & Staff Development

• Directly supervise billing, collections, payment posting, insurance verification, and other revenue cycle personnel. 
• Recruit, train, mentor, and evaluate staff performance. 
• Establish productivity standards and accountability measures. 
• Conduct regular team meetings and ongoing education. 

Payer Relations

• Maintain positive working relationships with commercial insurance carriers, Medicare, Medicaid, workers' compensation carriers, and third-party administrators. 
• Resolve escalated payer disputes and reimbursement issues. 
• Assist leadership with payer contract implementation and operational impacts. 

Cross-Department Collaboration

• Work closely with physicians, practice administrators, surgery scheduling, clinical staff, coding, and front office teams. 
• Improve communication between departments to reduce billing errors and improve patient satisfaction. 
• Support implementation of new services, providers, and technology affecting revenue cycle operations. 

Qualifications

Education

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or related field preferred. 
• Equivalent experience considered. 

Experience

• Minimum of 5 years of progressive revenue cycle management experience. 
• Minimum of 3 years in a leadership or management role. 
• Experience within surgical,  multispecialty, or physician practice strongly preferred. 
• Experience managing high-volume physician billing operations. 

Preferred Certifications

• Certified Revenue Cycle Representative (CRCR) 
• Certified Professional Coder (CPC) 
• Certified Professional Medical Auditor (CPMA) 
• Certified Healthcare Financial Professional (HFMA) 

Knowledge, Skills & Abilities

• Extensive knowledge of physician billing and reimbursement. 
• Strong understanding of surgical coding and reimbursement. 
• Detailed knowledge of Medicare, Medicaid, commercial insurance, workers' compensation, and personal injury billing. 
• Experience with EHR and practice management systems. 
• Advanced Microsoft Excel and reporting skills. 
• Strong analytical and financial management abilities. 
• Excellent leadership, communication, and organizational skills. 
• Ability to manage multiple priorities in a fast-paced healthcare environment. 
• Strong problem-solving and decision-making skills. 
• High level of professionalism, integrity, and confidentiality. 

Physical Requirements

• Prolonged periods of sitting and computer work. 
• Occasional standing, walking, and lifting up to 20 pounds. 
• Ability to communicate effectively in person, by telephone, and electronically. 

Work Environment

• Professional medical office environment. 
• Standard business hours with occasional extended hours as needed to meet operational demands. 

Benefits 

• Competitive salary 
• Medical, Dental, and Vision Insurance 
• Paid Time Off 
• Paid Holidays 
• 401(k) with employer match 

This position plays a critical leadership role in maximizing the financial health of the practice while ensuring compliance, operational excellence, and an exceptional patient financial experience. The Revenue Cycle Manager is expected to foster a culture of accountability, continuous improvement, and collaboration across all revenue-generating functions of the organization.