Revenue Cycle Manager - Billing Operations - Life Flight Network - Work at Home

easyservice; Toledo (OH); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Mercy Health in Toledo, OH is seeking a leader to oversee the EMS Transportation billing and revenue cycle operations. You will direct daily claims submission, posting, A/R follow-up, denials management, and payer communications to ensure accurate and timely reimbursement for ground and air transport services.

In this role you will develop billing staff, set performance expectations, analyze financial metrics, and collaborate with EMS operations, Finance, and payers to improve revenue

Qualifications

• Requires leadership of EMS Transportation billing operations and staff.
• Experience with claim submission, payment posting, A/R follow-up, denials, and payer communications.
• Knowledge of Medicare/Medicaid and commercial payer requirements a plus.

Responsibilities

• Lead EMS Transportation billing operations to ensure accurate, timely submissions.
• Develop staff through coaching, evaluations, and training programs.
• Monitor KPI like days in A/R, clean claim rate, and denial trends.
• Coordinate insurance filing and payment posting, reconciliation, and issue resolution.
• Provide regular financial and operational reporting to leadership.

Job description

Thank you for considering a career at Mercy Health!

Scheduled Weekly Hours: 40

Work Shift: Days (United States of America)

Provides leadership and oversight for the EMS Transportation billing and revenue cycle operations, ensuring timely, accurate, compliant, and fiscally responsible billing and collection activities for ground and air medical transportation services. Directs and develops billing staff, establishes and monitors performance expectations, and partners with EMS operations, Revenue Cycle, Finance, payers, and other organizational stakeholders to optimize revenue realization, reduce accounts receivable, resolve billing and payer issues, and improve the overall patient financial experience. Responsible for the day-to-day management of EMS Transportation billing operations, including claim submission, payment posting, accounts receivable follow-up, denial and underpayment management, insurance verification and authorization processes, billing compliance, financial reconciliation, and reporting. Utilizes data and financial analytics to identify trends, develop corrective action plans, improve operational performance, and support strategic decision-making.

Essential Job Functions

• Provides leadership and oversight of EMS Transportation billing operations. Ensures daily billing activities are completed accurately and timely, including claim submission, payment posting, account follow-up, denial management, correspondence, adjustments, refunds, and account resolution.
• Manages and develops billing staff. Establishes performance expectations, monitors productivity and quality, conducts regular staff check-ins and evaluations, provides coaching and corrective action as appropriate, and promotes professional development and accountability.
• Develops and maintains billing training programs. Oversees orientation and training for new employees and provides continuing education related to EMS billing requirements, payer requirements, organizational policies, billing systems, regulatory changes, and revenue cycle processes.
• Monitors EMS Transportation revenue cycle performance. Develops, maintains, and analyzes key performance indicators, including point-of-service collections, days in accounts receivable, aging, cash collections, denial rates, clean claim rates, claim submission timeliness, payment variance, productivity, and other department-specific metrics.
• Coordinates insurance billing and accounts receivable management. Oversees insurance filing, claim status follow-up, payer correspondence, payment posting, account reconciliation, denial and rejection resolution, underpayment identification, and escalation of complex payer issues.
• Ensures accurate and timely financial reconciliation. Oversees daily deposits, payment posting, adjustments, refunds, and daily/monthly balancing activities. Coordinates monthly financial and compliance audits and investigates and resolves discrepancies.
• Partners with EMS operational leadership to improve financial performance. Uses financial and operational data to identify opportunities for improvement, develops action plans, and collaborates with operational and clerical teams to improve documentation, billing accuracy, charge capture, authorization processes, collection performance, and overall revenue cycle results.
• Monitors payer requirements and revenue cycle compliance. Maintains working knowledge of Medicare, Medicaid, commercial payer, and other applicable EMS transportation billing requirements. Ensures departmental processes are consistent with organizational policies, payer requirements, and applicable regulatory and compliance standards.
• Manages denial, rejection, and underpayment trends. Identifies recurring payer and billing issues, analyzes root causes, tracks financial impact, and coordinates appropriate corrective actions with billing staff, EMS operations, Revenue Cycle, Finance, and payer representatives.
• Supports the development and implementation of EMS Transportation billing processes and procedures. Identifies opportunities to streamline workflows, improve system utilization, reduce manual work, increase automation, and strengthen controls throughout the revenue cycle.
• Coordinates departmental staffing and scheduling. Develops and maintains staff schedules, coordinates coverage for time off and call-offs, monitors staffing needs, and balances staffing levels with operational demands while minimizing unnecessary overtime.
• Provides financial and operational reporting to leadership. Prepares and presents regular reports regarding billing performance, accounts receivable, collections, payer performance, denials, productivity, and other relevant financial and operational measures. Escalates significant trends, risks, and opportunities to appropriate leadership.
• Supports system and departmental projects. Participates in and/or leads projects involving billing systems, payer initiatives, process changes, revenue cycle improvements, technology implementatio