Revenue Cycle Manager - Prior Authorization & Billing

Page Mechanical Group, Inc.; Huntington Beach (CA); Hybrid; USD 110,000 - 150,000; Full time

Benefits offered by this job

Vacation and Sick Pay

Day shift schedule

Nights and Weekends Off

Medical/Vision/Drug Insurance

Dental Insurance

401k Plan with Matching up to 5%

Tuition Reimbursement Program

Referral Bonus Program

Life Insurance

Wellness Resources

9 Holidays and 2 Floating Holidays

Job summary

Advantage Healthcare Services' Corporate Office in the United States is seeking a Revenue Cycle Management Manager to lead the Prior Authorization and Medical Billing teams in a hybrid setting. You will oversee end-to-end revenue cycle processes, driving performance, accuracy, and compliance across payers and regulations.

The role emphasizes developing training, optimizing workflows, and partnering with clinical and operations leaders to resolve complex payer issues.

Qualifications

• MBA or master's degree in a related field is required.
• CPC (Certified Professional Coder) certification; CHCO or comparable healthcare compliance certification preferred.
• Specialty pharmacy practice experience with high-cost injectable or buy-and-bill reimbursement preferred.
• Experience with authorization tracking and clearinghouse platforms expected.
• Experience leading offshore or distributed teams preferred.
• 5+ years in a revenue cycle management leadership role, preferably in specialty pharmacy or behavioral health.

Responsibilities

• Provide day-to-day leadership, coaching, and performance management for the Prior Authorization and Medical Billing teams.
• Establish and monitor KPIs such as authorization turnaround time, claim denial rates, and first pass resolution rates.
• Develop and continuously improve SOPs for prior authorization and billing workflows.
• Partner with payers to resolve escalated delays, appeals, and reimbursement disputes.
• Ensure billing practices comply with payer contracts and regulations.
• Oversee use of tracking, clearinghouse, and billing platforms; identify automation opportunities.
• Analyze denials and delays; implement corrective actions.
• Train and develop offshore or distributed staff; prepare regular performance reports.

Skills

Payer processing

Team leadership

Analytical skills

Medical billing & coding

Communication

RCM software

Project management

Problem solving

Education

MBA or MS

CPC certification

Healthcare compliance certification

Tools

Authorization tracking software

Clearinghouse platforms

Billing platforms

Job description

Advantage Healthcare Services' Corporate Office in the United States is seeking a Revenue Cycle Management Manager to lead the Prior Authorization and Medical Billing teams in a hybrid setting. You will oversee end-to-end revenue cycle processes, driving performance, accuracy, and compliance across payers and regulations.

The role emphasizes developing training, optimizing workflows, and partnering with clinical and operations leaders to resolve complex payer issues.