Job Summary: The Revenue Cycle Manager is responsible for overseeing the full revenue cycle process to ensure accurate, timely and compliant billing, coding, and collections for the Medical, Dental, Behavioral Health and Pharmacy services. This role manages all functions related to billing, coding, claims, collections, and payment posting functions while maintaining compliance with healthcare regulations and payer guidelines. The manager leads a team to achieve financial performance goals, optimize revenue capture, reduce denials, and enhance the overall patient financial experience. This position requires strong multi-inter-departmental collaboration and communication skills with Directors and managers. In the following departments: (Medical, Dental, Pharmacy, Behavioral Health, Accounting and Administration). The ideal candidate will have a strong understanding of healthcare billing practices, excellent analytical skills, and the ability to work collaboratively with various departments to ensure optimal revenue flow.
Job Duties & Responsibilities:
A. Develop strategies to improve operational efficiency and effectiveness of healthcare revenue cycle.
B. Evaluate billing staff performance and identify areas of improvement or concern.
C. Review operational budgets and recommend changes to Director.
D. Oversee the hiring and training of new billing staff members and ensure their performance is compliant with company policies.
E. Work closely with the Clinic Office Manager regarding PRC, patient registration and insurance verification.
F. Oversite of coding, billing, charge capture, clean claims submission, payment posting, and collections.
G. Develop and implement policies and procedures that ensure efficient workflows and regulatory compliance.
H. Monitor key performance indicators (KPIs) such as days in A/R, clean claim rates, denial rates, and collection percentages.
I. Supervise, train, and evaluate billing staff. Provide coaching, support, and development opportunities for team members.
J. Ensure adherence to HIPAA, Medicare, Medicaid, and commercial payer rules and regulations.
K. Conduct regular audits to verify billing accuracy and compliance with internal standards.
L. Generate and analyze financial and operational reports related to revenue cycle performance.
M. Work closely with finance and clinical departments to align revenue cycle goals with overall business strategy.
N. Lead initiatives to reduce claim denials and accelerate accounts receivable collection.
O. Collaborate with payers to resolve outstanding claims and reimbursement issues
Education & Experience: Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field and five (5) years of progressive experience in healthcare revenue cycle management, including supervisory experience is required. Experience with physician practice, dental practice and behavioral health environments preferred. Prefer experience with American Indian/ Alaska Native communities.
Certifications:
- Certified Billing or Coding Specialist required.
- Healthcare Management Certification preferred.
- Certified Accounts Receivable Professional (CARP) preferred.
Job Knowledge: Strong knowledge of Medicare, Medicaid and commercial payers billing process and regulations. Strong understanding of healthcare billing processes, healthcare regulations, EOBs (Explanation of Benefits), EFTs (Electronic Funds Transfers), and ERAs (Electronic Remittance Advice). Allocate resources effectively to meet departmental and organizational goals. In-depth knowledge of medical billing, coding (ICD-10, CPT, HCPCS), and payer guidelines. Proficiency in healthcare billing software and EHR systems (e.g., Epic, Cerner, NextGen, Dentrix, IHS/EHR). Excellent leadership, communication, and interpersonal abilities.
Job Type: Full-time
Pay: $40.29 - $50.36 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Application Question(s):
- How many years of experience do you have working with American Indian/Alaska Native Communities?
Education:
Experience:
- Healthcare Revenue Cycle Management: 5 years (Required)
- supervisory : 2 years (Required)
License/Certification:
- Billing or Coding Specialist Certification (Required)
- Healthcare Management Certification (Preferred)
- Accounts Receiveable Professional (CARP) Certification (Preferred)
Ability to Commute:
- Oakville, WA 98568 (Required)
Work Location: In person
