The Revenue Cycle Manager is responsible for fostering the department’s development and expansion through various responsibilities. These include identifying organizational requirements, recruiting, training, and overseeing personnel. Additionally, they play a crucial role in advising the Executive Leadership Team on matters pertaining to the revenue cycle, contributing to strategic decision-making. The manager’s role is pivotal in driving continual enhancements to critical revenue cycle metrics and optimizing all facets of the billing process.

Essential job duties:

• Coordinate and support payer contracts by maintaining and updating payer contracts list; implementing contract requirements and troubleshooting revenue issues with provider representatives; reporting on utilization and comparing to practice management (PM) system; implement grant and value-based contracts, ensuring compliance and tracking via the PM system.
• Develop, mentor, manage, and train revenue cycle staff, including timely feedback and annual reviews.
• Coordinate with multiple departments and managers to ensure proper workflows, training, and follow-up for patient intake and revenue capture.
• Collaborate with Epic and OCHIN on JIRA details related to revenue cycle activities.
• Provide support and guidance on coding and documentation issues; feedback to providers on corrections; implementation of new services; managing coding audits and improvement projects; training and coordination with back office and billing staff to correct coding errors.
• Create, implement, and monitor KPIs specific to the revenue cycle function to monitor performance and identify areas for improvement.
• Prepares monthly wrap submissions, quarterly reconciliations, and appeals for PPS reimbursement from OHA.
• Manage APM (Alternative Payment Models) patient enrollment and appeals.

Education and experience:

• Bachelor’s degree in healthcare administration, business administration, finance or related field preferred.
• Two years’ revenue cycle management experience is required.
• Four years’ revenue cycle experience, including Medicare and Medicaid billing, is required.
• Experience with the unique regulatory and compliance requirements governing FQHCs, including Medicare and Medicaid billing guidelines, is preferred.
• Experience with Epic electronic health record software is preferred.

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