Overview
Carolina Community Group is seeking a highly organized and results-driven Revenue Cycle Manager to oversee and optimize the entire revenue cycle process. This position is responsible for managing claims submission, payment posting, denial management, accounts receivable, payer follow-up, revenue tracking, and reporting to ensure the financial health of the organization.
The ideal candidate will possess strong knowledge of healthcare reimbursement processes, revenue cycle management, and insurance billing. Experience with behavioral health claims, Medicaid managed care organizations, and behavioral health reimbursement is strongly preferred. This is a temporary-to-permanent opportunity with the potential for long-term employment based on performance and organizational needs.
Duties and Responsibilities
- Oversee the end-to-end revenue cycle process from service delivery through payment collection.
- Monitor and manage claims workflows to ensure timely claim submission and reimbursement.
- Develop and maintain revenue cycle policies, procedures, and performance standards.
- Identify and resolve bottlenecks impacting cash flow and reimbursement timelines.
- Track key performance indicators (KPIs) related to revenue cycle operations.
- Supervise claim submission processes and ensure claims are submitted accurately and timely.
- Monitor claim status and coordinate follow-up activities on unpaid, denied, or rejected claims.
- Analyze denial trends and implement corrective action plans to reduce future denials.
- Work closely with billing staff, providers, and payers to resolve claim issues.
- Ensure compliance with payer requirements and reimbursement guidelines.
- Track all organizational revenue and maintain accurate revenue reporting.
- Reconcile payments and identify revenue discrepancies.
- Prepare weekly and monthly revenue cycle performance reports.
- Monitor accounts receivable aging and establish collection strategies.
- Forecast revenue trends and provide recommendations to leadership.
- Serve as a liaison between the organization and insurance payers.
- Maintain knowledge of Medicaid, Medicare, commercial insurance, and managed care billing requirements.
- Assist with payer credentialing and enrollment processes as needed.
- Ensure compliance with federal, state, payer, and organizational requirements.
- Train and support billing and claims staff.
- Collaborate with operations, clinical, and finance teams to improve workflow efficiency.
- Implement best practices and technology solutions to improve revenue cycle performance.
- Participate in audits and quality assurance reviews related to billing and revenue cycle activities.
Qualifications
Education
- Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or related field preferred.
- Equivalent experience may be considered in lieu of degree.
Experience
- Minimum of 3 years of healthcare revenue cycle management experience.
- Experience managing claims, accounts receivable, denials, and payer follow-up.
- Experience working with EHR and billing systems.
- Behavioral health billing and claims experience strongly preferred.
- Experience with Medicaid, Medicare, and managed care organizations preferred.
Pay: $26.00 per hour
Work Location: Remote
