Manager of Revenue Cycle

Confidential Posting; Miami (FL); On-site; USD 90,000 - 120,000; Full time

Job summary

Confidential Posting is seeking a Revenue Cycle Manager to oversee the daily operations of the revenue cycle team, ensuring efficient medical collection and billing processes. You will supervise Medical Collection and Medical Billing staff, maintain claim integrity, and drive KPIs in collaboration with leadership and vendors.

Responsibilities include managing denials, overpayments, appeals, and remittances; producing monthly metrics and reports; and hiring/training new staff to sustain high

Qualifications

• 3+ years’ experience in Revenue Cycle Management or 5+ as a Billing Specialist.
• Experience with electronic health record systems.
• Strong background in ICD10, CPT, HCPCS, Modifiers, E/M, EOB/EOP, CARC codes, and Billing rules.
• Microsoft Office applications (Excel, PowerPoint, Access, Outlook, Word) proficiency.
• Experience with analytic systems and data management systems is a plus (Tableau, Power BI, etc.).
• Excellent verbal and written communication skills.

Responsibilities

• Supervise the Revenue Cycle Management (RCM) associates (Medical Collectors, Medical Billers, etc.).
• Direct supervision of third-party vendor (e-Clinical Works Billing Services) for RCM.
• Ensure claim integrity and oversee correct coding and billing in every submission.
• Manage and audit denials, overpayments, appeals, remittances, and posting processes.
• Provide monthly overviews and actions to improve AR and other KPIs.
• Prepare and present monthly reporting metrics to leadership and stakeholders.
• Coordinate with Compliance, Credentialing, Medical Directors, and other departments on issues.
• Oversee patient billing/collection communications.
• Hire and train new staff.

Skills

Leadership

Communication

Detail oriented

Office suite

Analytics

Education

Bachelor’s degree in finance/business/healthcare

AHIMA/AAPC certification

Tools

EMR e-Clinical Works

Tableau

Power BI

MS Excel

Job description

Department: Revenue Cycle Management Reports to: Director of Revenue Cycle

ESSENTIAL FUNCTIONS

The Revenue Cycle Manager will be responsible for the supervision and well-functioning of the Revenue Cycle. The main responsibilities include direct supervision of Medical Collection associates and Medical Billing associates, ensuring claim integrity, monitoring claim submission, managing denials, overpayments, appeals efficiently, identifying any possible billing-related issues. The Revenue Cycle Manager will guide his/her Team to successful KPIs related to the industry. Direct Supervisor for our third-party vendors (EMR e-Clinical Works) Billing Company.

DUTIES AND RESPONSIBILITIES

• Management and supervision of the RCM associates (Medical Collector, Medical Billers, etc.)
• Direct supervision and feedback to e-Clinical Works Billing Services as a third-party vendor for our RCM.
• Ensure claim integrity, overseeing the correct coding and billing processes in every submission.
• Managing and auditing the Denial, Overpayments, Appeals, Remittances, and Posting processes.
• Monthly overview and specific actions to improve and maintain AR and other KPIs.
• Monthly reporting metrics.
• Report to supervisor and other departments (Compliance, Credentialing, Medical Directors, etc.) about any related issues.
• Efficiently managing patient correspondence relating to billing and collections.
• Hire and training of new staff.

SUPERVISORY RESPONSIBILITIES

• This position has supervisory responsibilities.

QUALIFICATIONS/REQUIREMENTS

• Medical Coding & Billing certifications from AHIMA/AAPC (CPC, CCS, RHIT, CPB, CPMA)
• 3+ years’ experience in Revenue Cycle Management or 5+ as a Billing Specialist.
• Bachelor’s degree in finance, business administration, healthcare administration, or related field preferred.
• Experience with working in electronic health record systems.
• Strong background in ICD10, CPT, HCPCS, Modifiers, E&M, EOB/EOP, CARC codes, and Billing rules.
• Microsoft office applications (MS Excel, MS PowerPoint, MS Access, MS Outlook, MS Word) proficiency
• Experience with analytic systems and data management systems is a plus (Tableau, MS Power BI, etc.)
• Strong leadership skills to work collaboratively with customers, associates, and leaders within the organization.
• Managing staff performance by providing regular feedback, performance reviews, and one-on-one meetings.
• Excellent verbal and written communication skills.
• High level of organization and follow-up.
• Strong attention to detail.

WORKING CONDITIONS

General office working conditions.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function.

While performing the duties of this job, the employee will be required to stand, walk, sit, use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs, balance; stoop, kneel, crouch or crawl; talk or hear. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust your focus. Manual dexterity is required to use desktop computers and peripherals.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of his job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

TRAVEL

Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected.