Revenue Cycle Manager

Southern Pediatrics; Nashville (TN); On-site; USD 85,000 - 115,000; Full time

Job summary

Southern Pediatrics seeks a Revenue Cycle Manager to lead end-to-end billing, coding, and collections for 60-75 providers across locations. You will manage a 7- to 10-member team, drive KPI improvements, and partner with payers to safeguard revenue integrity.

The role requires five years in healthcare revenue cycle with leadership, knowledge of payer portals (Athena/Availity), and a bachelor's degree in a related field. Certification is a plus.

Qualifications

• Bachelor's degree or equivalent in a related field; experience preferred.
• Minimum five years in healthcare revenue cycle with leadership experience.
• Certification such as CRCR, CPC, CCS, RHIT, or RHIA preferred.

Responsibilities

• Lead daily revenue cycle operations for 60-75 providers across locations.
• Mentor and develop a billing team and conduct performance reviews.
• Monitor KPIs like clean claim rate, denial rate, and days in A/R.
• Design and improve revenue cycle policies and internal controls.
• Oversee claim submissions, denials, appeals, and payer contract analysis.
• Oversee collections and follow-up with insurers and patients for timely payment.
• Ensure billing compliance with federal/state/payer regulations.

Skills

Revenue cycle leadership

Team management

Payer portals & systems

Analytics & KPI interpretation

Regulatory knowledge (revenue cycle)

Education

Bachelor's degree in healthcare administration / business / finance

High school diploma or GED with revenue cycle experience

Tools

Athena

Availity

Microsoft Office

Job description

The Revenue Cycle Manager leads Southern Pediatrics' end-to-end revenue cycle for approximately 60-75 providers. This position is accountable for ensuring timely, accurate, and compliant billing, coding, and collections across assigned providers and locations. This position will manage a team of 7 to 10 direct reports with billing and A/R responsibilities. This position designs and improves revenue cycle processes, manages and develops a billing team, monitors key performance indicators, and partners with providers and payers to maximize clean claim rates, reduce accounts receivable days, and safeguard revenue integrity.

RESPONSIBILITIES

This position has a variety of job responsibilities, and the Company reserves the right to add or modify the job duties at any time based on the needs of the business and patient care. Below lists out the primary job responsibilities:

• Lead and oversee daily operations of the revenue cycle management, including billing, coding, collections, and cash and payment posting for assigned providers (typically 60-75) and locations
• Manage, mentor, and develop billing team, including hiring, training, performance evaluations, and coaching
• Monitor and drive key performance indicators, including clean claim rate, denial rate, A/R aging and days in A/R, and net collection rate, and report results to leadership
• Design, implement, and continuously improve revenue cycle policies, workflows, and internal controls to accelerate cash flow, address the root causes of delayed payments, and protect revenue integrity
• Oversee timely and accurate claim submission, denial management, and appeals, and analyze payer contracts and reimbursement to recover underpayments and lost revenue
• Oversee collections and follow-up, including reviewing unpaid claims, resolving denied claims, and working with insurance companies and patients to secure timely payment
• Ensure compliance with federal, state, and payer regulations governing coding, billing, and reimbursement, and partner with providers on clinical documentation and code selection
• Follow Company policies, procedures, and operational guidelines, including completing required training and adopting new skills, technologies, or systems that are introduced to support patient care and business needs

QUALIFICATIONS

• Minimum education: bachelor's degree in healthcare administration, business, finance, or a related field preferred; high school education or GED with equivalent revenue cycle experience required
• Experience: minimum of five years of healthcare revenue cycle experience, including at least two years in a supervisory or leadership role, required; experience in pediatrics or primary care and in medical billing and coding is preferred
• Certification such as CRCR, CPC, CCS, RHIT, or RHIA is preferred

POSITION SKILLS

• Strong understanding of the end-to-end revenue cycle, including coding, billing, collections, and reimbursement for commercial insurance and government payers (Medicaid/TennCare, TriCare)
• Proven leadership skills with the ability to manage, coach, and develop a team to meet productivity and performance targets
• Proficiency with revenue cycle systems and payer portals (e.g., Athena, Availity) and Microsoft Office
• Strong analytical and problem-solving skills, including the ability to interpret KPIs, EOBs, payer contracts, and clinical documentation to identify and resolve revenue issues
• Working knowledge of regulations governing the healthcare revenue cycle and of pediatric billing best practices, with strong time management, attention to detail, and effective written and verbal communication