Revenue Cycle Manager

University of the Pacific; Stockton (CA); On-site; USD 95,000 - 119,000; Full time

Job summary

University of the Pacific in Stockton, CA seeks a Revenue Cycle Manager to oversee the clinic revenue cycle from pre-claim review to final payment, ensuring compliant reimbursement from Medicare, Medi-Cal, commercial insurance, and self-pay accounts.

Lead the billing team, monitor KPIs, optimize workflows, and ensure timely collections while maintaining regulatory compliance with HIPAA, CMS and state/federal rules.

Qualifications

• Proven ability to communicate with diverse populations.
• Ability to produce concise professional reports.
• Analyze financial reports and KPIs to guide decisions.
• Ability to lead and develop teams.
• Maintain confidentiality of sensitive information.

Responsibilities

• Direct and oversee the clinic revenue cycle management function.
• Manage the claims lifecycle from entry to payment resolution.
• Ensure accurate billing for Medicare, Medi-Cal, commercial insurance, and self-pay.
• Monitor KPIs: net/gross collection rate, AR aging, denials.
• Develop and optimize revenue cycle workflows and processes.

Skills

Communication

Report writing

KPI analysis

Leadership

Confidentiality

Education

Bachelor's degree in related field

Tools

Microsoft Excel

Microsoft Word

Microsoft Access

Job description

Revenue Cycle Manager

Primary Purpose: Under the general supervision of the Director of Patient Financial& Revenue Cycle (DPFRC) The Revenue Cycle Manager isresponsible for the overall management and performance of theClinic and patient revenue cycle, ensuring timely and accuratereimbursement from Medicare, Medi-Cal, commercial insurance,managed care, and private payers. This position oversees allbilling office operations from pre-claim review through finalpayment resolution, including coding, claims submission, accountsreceivable, denials management, collections, credentialing,compliance, and reporting.

The Revenue Cycle Manager develops policies, monitors keyperformance indicators (KPIs), ensures regulatory compliance,improves operational efficiencies, and leads the billing team tomaximize cash collections while maintaining exceptional organization andregulatory compliance.

University of the Pacific recognizes that diversity, equity, andinclusion is foundational to the success of our valued students andemployees. We prioritize policy and decision-making thatdemonstrates awareness of, and responsiveness to, the wayssocio-cultural forces related to race, gender, ability, sexuality, socio-economic status, etc. impede orpropel students, faculty, and staff.

Essential Functions

• Direct and oversee all aspects of the clinic revenue cyclemanagement function, ensuring efficient and compliant billingoperations.
• Manage the complete claims lifecycle, including charge entry,claims submission, payment posting, denial management, and accountresolution.
• Ensure accurate and timely billing and reimbursement forMedicare, Medi-Cal, commercial insurance, managed care, andself-pay accounts.
• Monitor billing accuracy, clean claim rates, and key revenuecycle performance metrics.
• Develop, implement, and optimize revenue cycle workflows,processes, and improvement initiatives to enhance revenue capture,billing accuracy, collection performance, reimbursement speed,workflow efficiency, automation, customer satisfaction, and overallfinancial outcomes while reducing claim turnaround times.
• Oversee and ensure timely follow-up on unpaid claims tomaximize collections and reduce accounts receivable aging.
• Monitor accounts receivable aging and collectionperformance.
• Establish collection priorities and productivity goals, analyzereimbursement trends.
• Identify and resolve payment delays through corrective actions,reduce aged receivables, and oversee write-offs and contractualadjustments.
• Develop and implement denial prevention strategies by analyzingdenial trends, coordinating appeals, and ensuring timely submissionof reconsiderations, corrected claims, and rebilling activities tomaximize reimbursement and reduce future claim denials.
• Maintain compliance and documentation with all applicableregulations, including the contracted fee schedules, CaliforniaMedi-Cal regulations, HIPAA, CMS documentation requirements, andstate and federal billing regulations.
• Responsible for monitoring, reporting and improving on thefollowing key performance indicators but not limited to. NetCollection Rate, Gross Collection Rate, Days in Accounts
• Receivable, Aging by Payer, Cash Collections, Charge Lag,Denial Rates, Payment Variances, Bad Debt Trends, and ProductivityMetrics.
• Provide recommendations to executive leadership forimprovements.
• Supervise and mentor billing office personnel by establishingproductivity standards, delivering training and developmentprograms, and fostering a collaborative, accountable, andhigh-performing team environment.
• Conduct introductory and annual performance reviews.
• Coordinate with billing software vendors, clearinghouses,collection agencies, payment vendors, and insurance representativesand monitor vendor performance.
• Coordinate and oversee internal billing audits, Medicareaudits, Medi-Cal audits, ROC audits, and documentation reviews, andimplement corrective action plans as needed to ensure regulatorycompliance.
• Perform all other duties as assigned by the Director of PatientFinancial & Revenue Cycle.

Minimum Qualifications

Knowledge of

• Insurance billing, appeals, collections, and contractualadjustments.
• Dental/Medical insurance credentialing
• Demonstrated ability to manage time effectively, balancemultiple priorities, and drive tasks and projects to successfulcompletion. Proven track record of navigating complex and urgentissues with clarity and efficiency.
• Dental terminology/treatment and insurance procedures.
• Electronic dental billing systems.
• Accounting/billing procedures.
• Principles of management and supervision.
• Microsoft Excel, Word, and Access.

Ability to

• Communicate effectively with a diverse population of patients,students, staff, faculty and administration.
• Produce professional and concise reports and writtencorrespondence.
• Analyze financial reports, and KPI's to make appropriaterecommendations.
• Ability to meet benchmarks in a fast-pace high-volumesetting
• Work independently with minimal supervision.
• Provide effective leadership, training, and supervision.
• Maintain confidentiality of information.
• Demonstrate professional judgment in all situations.
• Manage multiple projects and consistently meet deadlines.

Experience

• Minimum of 3-5 years dental insurance claims processingexperience.
• Minimum 3 years increasingly responsible management experience,preferably in a dental or medical office.
• Minimum 3 years experience in Revenue Cycle Management.

Education

• Bachelor's degree in related field or 4 years relevantexperience.

Preferred Qualifications

Ability to

• Communicate effectively with a diverse population of patients,students, staff, faculty and administration.
• Provide effective leadership, training, and supervision.
• Demonstrate professional judgment in all situations.

Experience

• Experience in dental group practice or dental school is highlydesirable.
• Bilingual skills helpful.

Other

• Experience and sensitivity in working with people of diversebackgrounds and cultures.
• Ability to engage and integrate culturally responsive practicesand knowledge in their work.

Physical Requirements

• Work performed is primarily office/administrative with frequentuse of computer, mouse, and telephone.
• Requires sitting most of the working day; occasionallystanding, bending and walking.

Hiring Range

$95,000.00 - $119,000.00 per year. We considerfactors such as, but not limited to, scope and responsibilities ofthe position, candidate's qualifications, internal equity, as wellas market and organizational considerations when extending anoffer.

Background Check Statement

All applicants who receive a conditional offer of employment arerequired to execute a release and authorization for a backgroundscreening.

AB 810 Misconduct Disclosure Requirement:University of the Pacific complies with California Assembly Bill810, requiring candidates accepting conditional job offers to disclose any final administrative or judicial findings, ongoingproceedings, allegations, resignations under investigation, orappeals related to sexual harassment or misconduct within the pastseven years.