POSITION SUMMARY
The Revenue Cycle Manager leads Southern Pediatrics' end-to-end revenue cycle for approximately 60-75 providers. This position is accountable for ensuring timely, accurate, and compliant billing, coding, and collections across assigned providers and locations. This position will manage a team of 7 to 10 direct reports with billing and A/R responsibilities. This position designs and improves revenue cycle processes, manages and develops a billing team, monitors key performance indicators, and partners with providers and payers to maximize clean claim rates, reduce accounts receivable days, and safeguard revenue integrity.
POSITION RESPONSIBILITIES
This position has a variety of job responsibilities, and the Company reserves the right to add or modify the job duties at any time based on the needs of the business and patient care. Below lists out the primary job responsibilities:
Lead and oversee daily operations of the revenue cycle management, including billing, coding, collections, and cash and payment posting for assigned providers (typically 60-75) and locations
Manage, mentor, and develop billing team, including hiring, training, performance evaluations, and coaching
Monitor and drive key performance indicators, including clean claim rate, denial rate, A/R aging and days in A/R, and net collection rate, and report results to leadership
Design, implement, and continuously improve revenue cycle policies, workflows, and internal controls to accelerate cash flow, address the root causes of delayed payments, and protect revenue integrity
Oversee timely and accurate claim submission, denial management, and appeals, and analyze payer contracts and reimbursement to recover underpayments and lost revenue
Oversee collections and follow-up, including reviewing unpaid claims, resolving denied claims, and working with insurance companies and patients to secure timely payment
Ensure compliance with federal, state, and payer regulations governing coding, billing, and reimbursement, and partner with providers on clinical documentation and code selection
Follow Company policies, procedures, and operational guidelines, including completing required training and adopting new skills, technologies, or systems that are introduced to support patient care and business needs
POSITION QUALIFICATIONS
Below represents the intended qualifications for employees with this position:
Minimum education: bachelor's degree in healthcare administration, business, finance, or a related field preferred; high school education or GED with equivalent revenue cycle experience required
Experience: minimum of five years of healthcare revenue cycle experience, including at least two years in a supervisory or leadership role, required; experience in pediatrics or primary care and in medical billing and coding is preferred
Certification such as CRCR, CPC, CCS, RHIT, or RHIA is preferred
POSITION SKILLS
To be successful in this position, employees must demonstrate a diversity of skills related to revenue cycle leadership, analysis, and communication. Below are some of those skills:
Strong understanding of the end-to-end revenue cycle, including coding, billing, collections, and reimbursement for commercial insurance and government payers (Medicaid/TennCare, TriCare)
Proven leadership skills with the ability to manage, coach, and develop a team to meet productivity and performance targets
Proficiency with revenue cycle systems and payer portals (e.g., Athena, Availity) and Microsoft Office
Strong analytical and problem-solving skills, including the ability to interpret KPIs, EOBs, payer contracts, and clinical documentation to identify and resolve revenue issues
Working knowledge of regulations governing the healthcare revenue cycle and of pediatric billing best practices, with strong time management, attention to detail, and effective written and verbal communication
OUR MISSION AND VALUES
All positions at Southern Pediatrics are expected to represent and embody our mission and values:
Our mission: Southern Pediatrics exists to accelerate access to comprehensive care so all children have the opportunity to thrive.
Our values: we have three values, our ABCs – Action-oriented, always accountable; Boundless moves, bold hearts; Compassion in every connection.
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Parental leave
- Vision insurance
Experience:
- healthcare revenue cycle: 5 years (Required)
- supervisory healthcare revenue cycle: 2 years (Required)
Work Location: In person
