Backend Revenue Cycle Manager

Jobtailor; Deutschland; Remote; EUR 103.000 - 155.000; Vollzeit

Zusammenfassung

Jobtailor is seeking an experienced senior leader to oversee revenue cycle operations in a multi-regional setting. You will facilitate JOC sessions with major payers, manage vendor relations, and drive rapid resolution of high-dollar claim disputes while guiding a team of Senior Analysts.

Expect deep expertise in payer environments (UHC, BCBS, Cigna, Aetna, Humana) and a track record of maintaining contract provisions and escalation processes within a large healthcare organization.

Qualifikationen

• CCS credential preferred
• State licensure required where work is performed
• 3 years of leadership or management experience preferred
• Advanced revenue cycle certifications preferred
• Experience structuring JOC or payer-provider alignment frameworks
• Deep knowledge of major payer environments (e.g., UHC, BCBS, Cigna, Aetna, Humana)
• Experience with R1 RCM integrations

Aufgaben

• Facilitate and document approximately 45 monthly JOC executive sessions with key payers
• Maintain partnership agreements
• Share policy updates from JOC meetings with stakeholders
• Lead complex, high-dollar claim disputes across five regions
• Deploy advanced revenue integrity tactics to maximize reimbursement
• Oversee six escalation logs and ensure timely transmission
• Direct and develop Senior Analysts
• Establish review standards for denial inquiries and escalation docs
• Manage daily task allocation across regional priorities
• Conduct monthly reviews on aged inventory discussed at JOC
• Determine next steps with Legal or R1 RCM
• Stay aware of payer policy updates and contract provisions

Kenntnisse

Revenue cycle management

Leadership

Negotiation

Data analysis

Ausbildung

Bachelor's degree

Associate's degree

High School diploma equivalency

Tools

R1 RCM

Escalation logs

Vendor communication systems

Jobbeschreibung

• Facilitate and document approximately 45 monthly Joint Operating Committee (JOC) executive sessions with key commercial and government payers
• Maintain partnership agreements
• Share policy updates received during JOC meetings with appropriate parties
• Act as the primary escalation lead and senior negotiator for complex, high-dollar claim disputes and denials across five multi-state regions
• Deploy advanced revenue integrity tactics to drive rapid variance resolution and maximum reimbursement
• Direct continuous auditing, triage, and monthly transmission of six specialized escalation logs
• Oversee vendor communication streams, including R1 RCM, to ensure systematic inventory clearance and high-dollar account compliance with Ascension revenue standards
• Direct and develop Senior Analysts
• Establish review standards for claim denial inquiries and escalation documentation criteria
• Manage daily task allocation across competing regional priorities
• Conduct structured monthly reviews on aged inventory discussed at JOC meetings
• Determine whether items should be sent to Legal or R1 RCM for next steps
• Maintain awareness of payer policy updates and contract provisions

Requirements

• Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA) preferred
• Licensure required relevant to state in which work is performed
• High School diploma equivalency with 3 years of cumulative experience OR Associate's degree/Bachelor's degree with 2 years of cumulative experience OR 7 years of applicable cumulative job specific experience required
• 3 years of leadership or management experience preferred
• Advanced professional revenue cycle certification (e.g., CRCR, CSPR, or CSPPM) preferred
• Direct experience structuring and facilitating JOC or strategic payer-provider alignment frameworks
• Deep subject-matter expertise with major national and regional payer environments, including UHC, BCBS, Cigna, Aetna, and Humana
• Experience with vendor ecosystem integrations, including R1 RCM

Core Competencies

Demonstrates expertise in revenue cycle management, including advanced negotiation skills for high-dollar claim disputes and a strong understanding of payer environments. Proven ability to lead teams, manage complex projects, and ensure compliance with revenue standards.

Highest-signal resume keywords

• Certified Coding Specialist (CCS)
• Advanced Professional Revenue Cycle Certification
• Leadership Experience
• Joint Operating Committee (JOC) Facilitation
• Payer-Provider Alignment Frameworks

Hard Skills

• Revenue Cycle Management
• Claim Dispute Resolution
• Variance Resolution Tactics
• Auditing and Triage
• Escalation Documentation
• Inventory Management
• Payer Policy Awareness
• Contract Provisions Analysis
• Data Analysis
• Negotiation Skills

Soft Skills

• Communication
• Leadership
• Collaboration
• Problem-Solving
• Task Management

Certifications & Qualifications

• Certified Coding Specialist (CCS)
• Advanced Professional Revenue Cycle Certification

Industry Keywords

• Joint Operating Committee (JOC)
• Payer Environments
• UHC
• BCBS
• Cigna
• Aetna
• Humana
• Revenue Standards
• Compliance
• Healthcare Revenue Cycle

Tools & Technologies

• R1 RCM
• Escalation Logs
• Vendor Communication Systems