JOB DESCRIPTION
OBJECTIVE
The Revenue Cycle Manager oversees all aspects of the billing, collections, and revenue operations at Elevation Individual and Family Therapy, ensuring the financial health and sustainability of the practice. This role is responsible for developing and implementing billing policies, monitoring key financial indicators, ensuring payer compliance, and providing leadership over billing processes. This position requires a professional who combines strategic thinking with a hands-on approach, demonstrating the ability to perform day-to-day tasks directly while simultaneously leading process improvements and overseeing overall performance. The Revenue Cycle Manager serves as the point of contact for all billing-related matters, actively collaborating with leadership and administrative staff to maximize revenue and maintain smooth financial workflows. This is a hands-on leadership role where the Revenue Cycle Manager actively performs billing and credentialing tasks while also overseeing billing operations and ensuring financial health.
Essential Functions and Responsibilities
1. Revenue Cycle Oversight
Manage the full revenue cycle process, including insurance verification, claims submission, payment posting, denial management, and patient collections.
Develop, implement, and maintain clear billing policies, procedures, and standard operating procedures to ensure consistency and compliance.
Establish and monitor key performance indicators (KPIs), including but not limited to: days in A/R, clean claims rate, denial rates, collections, and net revenue.
Ensure accuracy in payer billing across Medicaid, Medicare, commercial insurance, EAP programs, and private pay clients.
Oversee the collections process, including identifying delinquent accounts, issuing final notices, and coordinating third-party collections when necessary.
Oversee and manage the credentialing and re-credentialing process for therapists with insurance payers, ensuring timely submission of applications, tracking of approval status, and maintenance of up-to-date provider records.
Handle and support critical revenue cycle functions, including insurance verification, claims submission, payment posting, denial resolution, patient collections, and therapist credentialing with insurance payers.
2. Billing and Financial Operations
Monitor and manage accounts receivable, ensuring timely follow-up on outstanding balances, underpayments, and contract payments.
Oversee patient billing communications, including statements, payment plans, and financial hardship requests.
3. Compliance and Audit Support
Maintain accurate and organized records of all billing-related documentation, including payer notices, contracts, and updates.
4. Collaboration and Communication
Provide clear and timely communication with clinical, administrative, and leadership teams regarding billing workflows, documentation requirements, and payer updates.
5. Team Supervision and Leadership
Directly perform key billing and revenue cycle tasks alongside the billing team, including claims submission, payment posting, denials management, collections, and credentialing.
Supervise internal billing staff and coordinate with external partners (e.g., clearinghouses, payer representatives, or contracted services) as needed to support billing workflows and resolve issues.
Qualifications
Associate’s degree in Healthcare Administration, Business, Finance, or related field (Bachelor’s preferred).
Strong understanding of Medicaid, Medicare, and commercial insurance billing processes, including behavioral health and outpatient services.
Proficiency with EHR and billing software, as well as Microsoft Office Suite (Excel, Word, Outlook).
