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Revenue Cycle Manager

Job Description - Revenue Cycle Manager





About CLS Health

CLS Health is a growing healthcare system in Houston, Texas that is taking a different approach to healthcare. We are a physician-led healthcare group that focuses on providing patients with holistic, multispecialty care. We're a dynamic team on a mission to provide better healthcare options for Houstonians!

Job Summary:

The Revenue Cycle Manager oversees and optimizes the revenue management processes within the company. The Revenue Cycle Manager must have a deep understanding of healthcare billing, coding, reimbursement, and compliance regulations, coupled with strong leadership and analytical abilities.

Supervisory Responsibilities:

  •  Directs and oversees Revenue Cycle Team.
  •  Conducts performance evaluations that are timely and constructive.

Duties/Responsibilities:

  • Revenue Cycle Optimization: Develop and implement strategies to streamline revenue cycle processes, including billing, coding, claims management, and collections, to maximize revenue and minimize delays.
  • Billing and Coding Compliance: Ensure accurate and compliant coding practices according to industry standards (e.g., ICD-10, CPT), payer guidelines, and regulatory requirements (e.g., HIPAA, CMS).
  • Claims Management: Oversee the timely submission, tracking, and resolution of claims to minimize denials and optimize reimbursement. Implement effective denial management strategies to address claim rejections and appeals.
  • Revenue Analysis and Reporting: Analyze revenue cycle performance metrics, identify trends, and generate insightful reports to monitor key performance indicators (KPIs) and inform decision-making processes.

Required Skills/Abilities:

  • Proficiency in medical billing software and revenue cycle management systems (e.g., Epic, Cerner, Meditech).
  • Strong knowledge of healthcare billing, coding, reimbursement methodologies, and compliance regulations (e.g., HIPAA, Medicare/Medicaid).
  • Excellent analytical skills with the ability to interpret data, identify trends, and develop actionable insights.
  • Effective leadership and team management skills, with a proven track record of motivating and developing high-performing teams.
  • Exceptional communication and interpersonal skills, with the ability to collaborate effectively across departments and with external stakeholders.

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental Insurance
  • Disability insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Requirements

Required Skills/Abilities:

  • Proficiency in medical billing software and revenue cycle management systems (e.g., Epic, Cerner, Meditech).
  • Strong knowledge of healthcare billing, coding, reimbursement methodologies, and compliance regulations (e.g., HIPAA, Medicare/Medicaid).
  • Excellent analytical skills with the ability to interpret data, identify trends, and develop actionable insights.
  • Effective leadership and team management skills, with a proven track record of motivating and developing high-performing teams.
  • Exceptional communication and interpersonal skills, with the ability to collaborate effectively across departments and with external stakeholders.

Education and Experience:

  • Bachelor's degree in healthcare administration, finance, business, or related field. Master's degree preferred.
  • Minimum of 5 years of experience in revenue cycle management, preferably in a healthcare setting.
  • Certified Professional Coder (CPC) or Certified Revenue Cycle Professional (CRCP) certification preferred.

Physical Requirements:

  • Prolonged periods sitting at a desk and working on a computer.
  • Must be able to lift to 15 pounds at times.

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