Commercial & Managed Care Revenue Cycle Manager

UCI Health; Anaheim (CA); On-site; USD 90,000 - 130,000; Full time

Job summary

UCI Health is seeking a Commercial/Managed Care Collections/Denials Manager to oversee hospital accounts receivable, denials, and workflow for Commercial, Managed Care, and government payers. You will drive first-pass clean billing, mentor staff, and coordinate with PFS leadership to resolve complex billing issues.

The role requires deep knowledge of CPT/HCPCS/ICD-10, strong communication, and the ability to analyze and report KPIs to optimize revenue recovery.

Qualifications

• 3+ years of experience in billing and collections for Commercial, Managed Care, Medicare, Medi-Cal and other programs.
• 5+ years of related experience in business office operations, consulting, or auditing.
• Strong knowledge of CPT, HCPCS and ICD-10 coding and payer requirements.
• Excellent verbal and written English communication including complex information.
• Demonstrated leadership to coach, mentor, and manage workflow and priorities.

Responsibilities

• Manage hospital A/R and the collections, denial, and workflow activities for Commercial/Managed Care payers.
• Ensure timely, accurate account evaluation, escalation, and resolution per procedures and regulations.
• Provide training, supervise performance, and conduct hiring and corrective actions as needed.
• Act as liaison between Patient Financial Services and department leaders to resolve charge, coding, and claim adjudication issues.
• Analyze performance indicators and dashboards to optimize revenue recovery and first-pass billing accuracy.

Skills

Billing & collections

Leadership

Communication

Analytical skills

Microsoft Office

CPT/HCPCS/ICD-10 knowledge

Time management

Regulatory compliance

Education

Bachelor's Degree in related area

Tools

EPIC EHR

Job description

UCI Health is seeking a Commercial/Managed Care Collections/Denials Manager to oversee hospital accounts receivable, denials, and workflow for Commercial, Managed Care, and government payers. You will drive first-pass clean billing, mentor staff, and coordinate with PFS leadership to resolve complex billing issues.

The role requires deep knowledge of CPT/HCPCS/ICD-10, strong communication, and the ability to analyze and report KPIs to optimize revenue recovery.