Revenue Cycle Manager

Job Description

Job Description

TITLE :

Revenue Cycle Manager

OVERVIEW :

Providing compassion and care isn’t just our profession at PHRI, it’s our passion…and culture. We care for the clients that we serve. We listen to them and provide the support that they need to enable them to live comfortable and fulfilling lives. Our drive is to restore hope and healing to the community. We are looking for mission driven professionals who want to join a transformational company with a big heart and make a difference in the community.

Currently serving over 1,500 patients in two different states and looking to grow to over 10,000 patients in 5 states, over the next 3-5 years. Its focus is advocating and implementing integrated care model approach to underserved population undergoing behavioral health related issues.

REPORTS TO :

Program Director / COO

CLASSIFICATION : W2

DATE APPROVED : July 2025

LOCATION : Washington D.C.

FTE

1.0

ENVIRONMENT / PHYSICAL DEMANDS

Standard Office / Sit, stand, walk, lift 15 lbs

JOB DESCRIPTION

POSITION SUMMARY :

The Revenue Cycle Manager is responsible for overseeing the end-to-end billing operations, including insurance verification, claims submission, payment posting, denials management, and collections. This role ensures that the organization’s financial operations are compliant, timely, and optimized for behavioral health reimbursement models—particularly Medicaid, Medicare, and managed care payers. The ideal candidate has deep experience in behavioral health billing and understands the complexities of ASAM-level reimbursement and documentation compliance.

DUTIES AND RESPONSIBILITIES

• Manage daily revenue cycle operations for all inpatient and outpatient services.
• Ensure accurate and timely insurance authorizations, verifications, and eligibility checks.
• Oversee claim submission process to Medicaid, Medicare, and commercial payers.
• Monitor A / R aging, denials, and follow-up activities to ensure maximum reimbursement.
• Partner with clinical, admissions, and intake teams to improve documentation and billing readiness.
• Implement best practices for billing workflows and staff performance.
• Train and supervise billing staff on compliance, CPT / HCPCS codes, ASAM documentation, and payer rules.
• Perform internal audits and respond to external payer reviews or audits.
• Maintain policies and procedures in accordance with changing payer and regulatory requirements.
• Provide regular reporting on revenue cycle performance to CFO and executive leadership.

EXPERIENCE AND QUALIFICATIONS

COMPETENCIES :

AAP / EEO STATEMENT :

It is the policy of Prestige Healthcare Resources, Inc. to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and / or expression, genetic information, marital status,

status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Prestige Healthcare Resources, Inc. will provide reasonable accommodation for qualified individuals with disabilities.