Job Summary
The Revenue Cycle Manager is responsible for the overall management and performance of the ambulance revenue cycle, ensuring timely and accurate reimbursement from Medicare, Medi-Cal, commercial insurance, workers’ compensation, managed care, and private payers. This position oversees all billing office operations from patient registration through final payment resolution, including coding, claims submission, accounts receivable, denials management, collections, customer service, compliance, and reporting.
The Revenue Cycle Manager develops policies, monitors key performance indicators (KPIs), ensures regulatory compliance, improves operational efficiencies, and leads the billing team to maximize cash collections while maintaining exceptional customer service and regulatory compliance.
Duties
Revenue Cycle Management
· Direct all aspects of the ambulance billing revenue cycle.
· Oversee claim processing from charge entry through payment posting and account resolution.
· Ensure accurate and timely billing of Medicare, Medi-Cal, commercial insurance, managed care, workers’ compensation, auto liability / personal injury, and self-pay accounts.
· Monitor clean claim rates and billing accuracy.
· Establish workflows that improve reimbursement and reduce claim turnaround times.
· Oversee timely follow-up on unpaid claims.
Accounts Receivable Management
· Monitor aging reports and collection performance.
· Establish collection priorities and productivity goals.
· Reduce aged receivables.
· Analyze reimbursement trends.
· Identify payment delays and implement corrective action.
· Monitor write-offs and contractual adjustments.
Denials Management
· Develop denial prevention strategies.
· Review denial trends.
· Coordinate appeals.
· Ensure timely reconsiderations and rebilling.
· Monitor overturn rates.
Ambulance Billing Compliance
· Maintain compliance with all applicable regulations, including the Medicare Ambulance Fee Schedule, California Medi-Cal regulations, HIPAA, CMS documentation requirements, OIG Compliance Guidance, the No Surprises Act (when applicable), and state and federal billing regulations.
· Ensure documentation supports billed services.
Coding Oversight
· Supervise coding staff to ensure correct HCPCS coding, proper modifier usage, ICD-10 diagnosis coding, medical necessity documentation, and compliance with CMS guidelines.
· Review coding audits and implement education as needed.
Financial Reporting
· Prepare and present reports including Net Collection Rate, Gross Collection Rate, Days in Accounts Receivable, Aging by Payer, Cash Collections, Charge Lag, Denial Rates, Payment Variances, Bad Debt Trends, and Productivity Metrics.
· Provide recommendations to executive leadership.
· Responsible for monitoring and improving the following key performance indicators
Team Leadership
· Supervise billing office personnel.
· Recruit, hire, train, and mentor staff.
· Conduct performance evaluations.
· Establish productivity standards.
· Develop training programs.
· Promote teamwork and accountability.
Process Improvement
· Identify opportunities to improve revenue capture, billing accuracy, collection rates, automation, workflow efficiency, and customer satisfaction.
· Lead revenue cycle improvement initiatives.
Customer Service
· Oversee staff responding to patient billing inquiries, insurance questions, payment arrangements, attorney requests, and provider inquiries.
· Ensure professional and compassionate customer service.
Vendor Management
· Coordinate with billing software vendors, clearinghouses, collection agencies, payment vendors, and insurance representatives.
· Monitor vendor performance.
Audit & Compliance
· Coordinate internal billing audits, Medicare audits, Medi-Cal audits, RAC audits, and documentation reviews.
· Implement corrective action plans when necessary.
Qualifications
Education
· Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or Accounting. Equivalent experience may be considered.
Experience
· Minimum 5–7 years of progressively responsible healthcare revenue cycle experience, including ambulance billing, Medicare reimbursement, Medi-Cal reimbursement, commercial insurance, accounts receivable management, and supervisory experience.
Knowledge
· Strong knowledge of ambulance reimbursement, CMS regulations, the Medicare Ambulance Fee Schedule, and the Medi-Cal Ambulance Program.
· Insurance billing, appeals, collections, and contractual adjustments.
· HIPAA, ICD-10, HCPCS coding, and medical necessity requirements.
Skills
· Leadership and staff development.
· Financial analysis and revenue cycle analytics.
· Process improvement and project management.
· Advanced Excel and billing software proficiency.
· Critical thinking, communication, and negotiation.
· Customer service.
Join us in leading our revenue cycle operations by ensuring seamless financial processes that support high-quality patient care while maintaining regulatory compliance!
Come be part of an exciting and fast paced team! Medic is on the cutting edge of EMS with exciting advancement opportunities.
Visit www.medicambulance.net to learn more about our company or to access our online application!
Medic Ambulance Service is an Equal Opportunity Employer and all qualified applicants will receive consideration without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
Pay: $140,000.00 - $180,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
