The Revenue Cycle Manager is responsible for managing and improving revenue cycle operations across KU MedWest ASC, LLC. This regional position works closely with facility leadership and teammates to ensure revenue cycle processes are accurate, timely, consistent, and support the financial performance of each facility and the organization as a whole.
The Revenue Cycle Manager provides oversight of the revenue cycle from patient registration through final account resolution, including insurance verification, authorizations, coding, charge capture, billing, claim submission, payment posting, accounts receivable, denials, appeals, collections, and patient balances.
While this position does not have direct reports, the Revenue Cycle Manager serves as the primary regional resource for revenue cycle matters and works collaboratively with facility leadership, Finance, Operations, payers, and external revenue cycle partners to identify issues, improve processes, and drive results.
Essential Duties and Responsibilities
Revenue Cycle Management
- Manage and monitor revenue cycle activities across KU MedWest ASC, LLC facilities.
- Serve as the primary regional resource for revenue cycle questions, issues, and process improvement.
- Monitor the revenue cycle from patient registration through final account resolution.
- Partner closely with facility leadership and teammates to support effective front-end and back-end revenue cycle processes.
- Monitor insurance verification, authorizations, coding, charge capture, billing, claim submission, payment posting, collections, and account follow-up.
- Identify gaps or breakdowns in revenue cycle workflows and work collaboratively with the appropriate facility or department to resolve them.
- Promote consistent revenue cycle processes and practices across facilities.
- Identify opportunities to improve accuracy, efficiency, reimbursement, and collections.
- Facilitate resolution of complex revenue cycle issues involving multiple departments, facilities, payers, or vendors.
Facility Partnership
- Build strong working relationships with facility Administrators, clinical leaders, providers, and administrative teammates.
- Maintain regular communication with facilities regarding revenue cycle performance, issues, trends, and opportunities.
- Work directly with facility teams to identify and resolve registration, authorization, documentation, charge capture, and other issues affecting reimbursement.
- Provide education, guidance, and support to facility teammates regarding revenue cycle processes and expectations.
- Help facilities understand how operational processes and decisions impact billing, reimbursement, denials, and collections.
- Participate in facility and regional meetings as appropriate.
- Collaborate with facility leadership on action plans when revenue cycle performance does not meet established expectations.
- Serve as a liaison between the facilities, Finance, Operations, payers, and external revenue cycle partners.
Accounts Receivable & Denial Management
- Monitor accounts receivable performance and aging across facilities.
- Identify trends in aged accounts and work with appropriate stakeholders to improve account resolution.
- Monitor claim denials and identify recurring trends and root causes.
- Coordinate with facilities, payers, and external partners to resolve denied or underpaid claims.
- Work with facility teams to address operational issues contributing to denials.
- Monitor authorization-related denials and collaborate with appropriate teams to improve processes.
- Identify underpayment trends and facilitate appropriate follow-up and resolution.
- Develop and track action plans to address revenue cycle performance concerns.
Performance Monitoring & Reporting
- Monitor key revenue cycle performance indicators at both the facility and regional levels.
- Prepare and communicate routine revenue cycle reports to Finance, Operations, and facility leadership.
- Analyze revenue cycle data to identify trends, risks, and opportunities for improvement.
- Monitor performance measures including days in accounts receivable, A/R aging, denial rates, clean claim rates, claim submission timeliness, collections, authorization-related denials, underpayments, unbilled accounts, and credit balances.
- Work with leadership to establish appropriate revenue cycle goals, benchmarks, and performance expectations.
- Provide actionable recommendations based on revenue cycle performance and trends.
- Track improvement initiatives and communicate progress to appropriate stakeholders.
Payer & Reimbursement Management
- Monitor payer trends and identify issues affecting reimbursement.
- Research and escalate recurring payer issues, denials, underpayments, and reimbursement concerns.
- Work with Finance, facility leadership, and appropriate external partners to resolve payer-related issues.
- Maintain working knowledge of payer requirements that affect ASC billing and reimbursement.
- Identify reimbursement trends that may have a financial impact on individual facilities or the organization.
- Support efforts to identify and recover inappropriate underpayments.
- Payor contract management
Vendor Management
- Serve as a primary point of contact for third-party billing, coding, clearinghouse, collection, or other revenue cycle vendors, as applicable.
- Monitor vendor performance against established expectations and key performance indicators.
- Coordinate regular vendor performance discussions and follow up on identified issues.
- Facilitate communication between vendors, facilities, and organizational leadership.
- Hold vendors accountable for timely issue resolution and agreed-upon performance expectations.
- Escalate significant vendor concerns to the Director of Finance.
- Assist leadership in evaluating vendor services and identifying opportunities for improvement.
Process Improvement & Education
- Identify opportunities to simplify, standardize, and improve revenue cycle processes across facilities.
- Partner with facility teams to develop practical solutions that support both operational needs and financial performance.
- Assist with developing and maintaining revenue cycle procedures, workflows, and resources.
- Provide education and guidance regarding revenue cycle processes, payer requirements, and identified trends.
- Support implementation of new revenue cycle processes, systems, or organizational initiatives.
- Monitor implemented changes to determine whether they are producing the intended results.
Compliance & Quality
- Support revenue cycle practices that comply with organizational policies, payer requirements, and applicable federal and state regulations.
- Promote accurate and compliant billing, coding, documentation, and reimbursement practices.
- Partner with appropriate resources to address identified billing, coding, documentation, or compliance concerns.
- Maintain confidentiality of patient and organizational information in accordance with HIPAA and organizational requirements.
- Support internal and external audits related to revenue cycle activities as needed.
- Assist with implementation and follow-up of corrective actions resulting from audits or identified concerns.
Bachelor's degree in healthcare administration, business administration, finance, accounting, or a related field. Equivalent relevant experience may be considered.
- Minimum of five (5) years of progressive healthcare revenue cycle experience.
- Demonstrated experience with healthcare billing, accounts receivable, denials, collections, reimbursement, and revenue cycle performance.
- Experience analyzing revenue cycle data and performance indicators.
- Working knowledge of healthcare reimbursement and payer processes.
- Demonstrated ability to identify issues, determine root causes, and coordinate solutions across multiple stakeholders.
- Strong written, verbal, analytical, and interpersonal communication skills.
- Ability to work independently while building collaborative relationships across multiple facilities and departments.
Preferred Qualifications
- Ambulatory Surgery Center (ASC) revenue cycle experience strongly preferred.
- Experience supporting revenue cycle operations across multiple facilities or locations.
- Experience working with outsourced billing, coding, or other revenue cycle vendors.
- Knowledge of Medicare, Medicaid, commercial insurance, managed care, and other payer requirements.
- Experience with revenue cycle systems, electronic health records, practice management systems, and clearinghouses.
- Professional certification in revenue cycle, healthcare finance, coding, or a related field preferred.
Knowledge, Skills & Abilities
- Strong knowledge of healthcare revenue cycle operations.
- Knowledge of ASC billing and reimbursement practices.
- Strong analytical and problem-solving skills.
- Ability to analyze financial and operational data and translate findings into practical recommendations.
- Ability to influence outcomes and drive accountability without direct supervisory authority.
- Strong collaboration and relationship-building skills.
- Ability to work effectively with Finance, Operations, clinical teams, providers, and facility leadership.
- Ability to communicate complex revenue cycle information in a clear and understandable manner.
- Strong attention to detail and commitment to accuracy.
- Ability to manage multiple priorities across multiple facilities.
- Ability to identify opportunities for process improvement and facilitate change.
- Proficiency with revenue cycle technology and Microsoft Office applications.
