Revenue Cycle Lead: Billing, Denials & Optimization

NECCO (ED Necco & Associates Inc.); Cincinnati, Northern (OH, KY); Hybrid; USD 75,000 - 95,000; Full time

Job summary

NECCO (ED Necco & Associates Inc.) in Cincinnati, OH is seeking a Senior Revenue Cycle Specialist to lead revenue cycle operations, including per diem and fee-for-service billing, denial management, and accounts receivable follow-up, in collaboration with the Revenue Cycle Manager.

The role provides guidance, training, and quality oversight, with a focus on reducing denials, improving reimbursement outcomes, and ensuring compliant, timely billing.

Qualifications

• Minimum of five (5) years of experience in healthcare revenue cycle operations, with demonstrated expertise in billing, accounts receivable follow-up, denial management, and reimbursement recovery
• Experience with Medicaid, Managed Care Organizations (MCOs), and governmental billing; behavioral health and per diem billing experience preferred
• Experience with EHR and clearinghouse systems
• Strong analytical, problem-solving, communication, and leadership skills, including experience training or mentoring team members
• Credentialing and enrollment experience and experience leading process improvement projects preferred
• Successful completion of all required criminal background checks
• Valid driver’s license and state minimum auto insurance

Responsibilities

• Act as lead resource and subject matter expert for Revenue Cycle operations
• Assist in establishing department standards, workflows, and best practices
• Provide guidance, training, onboarding, and cross-training support to Revenue Cycle team members
• Use data, trends, and root cause analysis to identify operational risks and reimbursement barriers and support measurable improvement
• Communicate effectively with team members, leadership, payers, and operational partners to resolve issues and support collaboration
• Assist Revenue Cycle Manager with special projects and strategic initiatives
• Monitor billing timeliness and accuracy and identify and resolve billing issues impacting reimbursement
• Collaborate with operational teams to resolve authorization, census, and invoicing concerns
• Develop standardized billing procedures and training materials
• Serve as operational lead for fee-for-service (FFS) billing activities
• Review billing workflows and identify opportunities to improve accuracy and reimbursement
• Provide support for complex billing issues and claim corrections
• Perform and oversee charge reconciliation processes
• Validate that services rendered are accurately reflected in billing systems and identify missing charges or revenue leakage
• Collaborate with clinical and operational teams to resolve discrepancies
• Recommend process improvements to reduce missed billing opportunities
• Lead investigation and resolution of complex denials
• Analyze denial trends and develop appeal strategies
• Prepare and submit high-value appeals
• Monitor appeal outcomes and identify opportunities for improvement
• Monitor aging accounts receivable and support reduction of aged balances
• Assist team members with complex reimbursement issues
• Review productivity and reimbursement trends Escalate payer issues as needed
• Serve as Revenue Cycle liaison for credentialing-related reimbursement issues
• Monitor credentialing impacts on billing and reimbursement and support escalation of enrollment and payer participation concerns
• Assist with development of credentialing workflows and tracking processes.
• Review coding-related billing trends and denial patterns and identify opportunities for coding education and documentation improvement
• Collaborate with providers, operations, and leadership to address recurring coding concerns
• Assist with implementation of coding-related billing edits and workflow improvements
• Stay informed of coding and payer requirements affecting reimbursement
• Perform quality reviews of billing, payment posting, appeals, and accounts receivable follow-up activities with a focus on accuracy, accountability, and attention to detail
• Monitor compliance with organizational policies and payer requirements
• Assist with auditing and quality improvement initiatives
• Lead workflow standardization efforts and develop and maintain department job aids and process documentation
• Assist with KPI development and monitoring and use results to identify barriers and support measurable outcomes
• Recommend automation and efficiency opportunities
• Participate in EHR and system improvement initiatives
• Supports timely and accurate billing, claim submission, payment posting review, and accounts receivable follow-up activities
• Contributes to reduced denials, improved appeal outcomes, decreased aged receivables, and increased reimbursement recovery
• Maintains consistent workflow documentation, job aids, and training resources that support team efficiency and cross-training
• Demonstrates measurable progress toward departmental goals, quality standards, process improvements, and financial sustainability
• Models Necco’s mission, vision, and values through professionalism, ownership, collaboration, and measurable results
• Maintains a solution-focused approach when working with internal teams, external partners, and cross-functional stakeholders
• Protects confidentiality and supports compliance with organizational policies, payer requirements, and regulatory expectations
• Contributes to a positive team culture by demonstrating accountability, respect, continuous learning, and commitment to building families

Skills

Revenue cycle

Billing

Accounts receivable

Denials & appeals

Credentialing

Process improvement

Training

Leadership

Job description

NECCO (ED Necco & Associates Inc.) in Cincinnati, OH is seeking a Senior Revenue Cycle Specialist to lead revenue cycle operations, including per diem and fee-for-service billing, denial management, and accounts receivable follow-up, in collaboration with the Revenue Cycle Manager.

The role provides guidance, training, and quality oversight, with a focus on reducing denials, improving reimbursement outcomes, and ensuring compliant, timely billing.