SALARY: Based on work experience
Position Summary
The Revenue Cycle Manager oversees all aspects of the revenue cycle to ensure accurate, timely, and compliant billing, reimbursement, and revenue collection for medical, dental, behavioral health, and other clinical services provided by CPACS Cosmo Health Center. This role is responsible for managing both front-end and back-end revenue cycle operations, including patient registration, insurance verification, charge capture, coding support, claims submission, payment posting, accounts receivable, denial management, collections, and patient financial services.
Reporting to the Financial Director, the Revenue Cycle Manager partners with clinical leadership, front office staff, billing staff, and other departments to optimize revenue cycle performance, improve operational efficiency, maximize reimbursement, and enhance the patient financial experience. The position also ensures compliance with all applicable federal and state regulations, payer requirements, and organizational standards, including HRSA, HIPAA, and FQHC requirements.
Duties and Responsibilities:
- Direct and oversee all functions of the revenue cycle from patient registration through final payment collection.
- Ensure accurate insurance eligibility verification, authorization, charge capture, and coding.
- Ensure timely claim submission, payment posting, and follow-up on unpaid claims.
- Monitors timeliness and effectiveness of department activities, ensuring that outstanding patient accounts and accounts receivable are no more than the agreed-upon limit and that bad debt is within the budgeted target.
- Lead denial management efforts by identifying trends, implementing corrective actions, and reducing denials.
- Compiles and prepares various reports and key performance indicators for management to analyze trends, make recommendations, and meet reporting requirements.
- Ensure all revenue cycle processes comply with federal, state, and organizational regulations, including medical billing and coding standards.
- Supervise billing and revenue cycle staff through coaching, performance evaluations, and ongoing professional development.
- Assist with budgeting, forecasting, and revenue planning.
- Serve as a liaison with insurance companies, government payers, and third-party vendors.
Education/Experience
- Bachelor's degree in Healthcare Administration, Business Administration, Finance, or related field preferred.
- Minimum of three (3) to five (5) years of experience in healthcare revenue cycle management.
- Experience working in a Federally Qualified Health Center (FQHC), Community Health Center, or multi-specialty outpatient clinic preferred.
- Experience with eClinicalWorks (eCW) or similar Electronic Health Record (EHR) systems preferred.
- Strong knowledge of CPT, ICD-10-CM, HCPCS coding, medical billing, and reimbursement methodologies.
Preferred Certifications
- Certified Revenue Cycle Representative (CRCR)
- Certified Healthcare Financial Professional (CHFP)
- Certified Professional Biller (CPB)
- Certified Professional Coder (CPC)
- Certified Coding Specialist (CCS)
- Certified Medical Reimbursement Specialist (CMRS)
- Fellow of the Healthcare Financial Management Association (FHFMA)
How to Apply
- Contact: Yun Yan
- Email: [email protected]
- Please submit your resume to the email above.
Pay: From $1.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
