Revenue Cycle Manager

Job Description

Job Description

Reporting to the Practice Administrator, the Revenue Cycle Manager will be responsible for overseeing and managing all aspects of the revenue cycle process within the organization. This includes prior authorizations, coding, charge entry, billing, payment posting, collections, compliance, provider enrollment and financial analysis to ensure optimal revenue generation and cash flow. The Manager will lead a revenue cycle team, implement best practices, and develop strategies to improve revenue cycle efficiency and effectiveness.

List of Responsibilities / Duties

• Develop and implement strategies to optimize revenue cycle performance, minimize denials, and maximize collections.
• Lead and manage the charge entry / coding team to ensure accurate and timely coding of all patient encounters.
• Oversee the billing process, ensuring accuracy, timeliness, and compliance with regulatory requirements and payer guidelines.
• Stay current with industry trends, regulations, and best practices related to revenue cycle management and healthcare finance.
• Develop and maintain effective relationships with payers, vendors, and other external stakeholders to facilitate revenue cycle operations.
• Participate in revenue cycle audits, compliance reviews, and other regulatory activities as necessary.
• Produce and analyze standard periodic reports such as A / R aging, denial reports, POS collections, revenues by provider / location / payer, and revenue forecasts based on payer mixes and rates. Monitor and analyze key performance indicators (KPIs) related to revenue cycle metrics, identify trends, and implement corrective actions as needed.
• Complete provider payer enrollment / credentialing and recredentialing with all identified payers in a timely manner.
• Proactively obtain updated provider credentialing data prior to expiration. Create, develop, and maintain applicable spreadsheets to support the enrollment functions. Complete all additions, updates, and deletions. Support new provider onboarding processes as related to enrollment.
• Actively participate in and comply with all aspects of Corporate Compliance Programs, follow the Program Code of Conduct and obey all relevant laws, statutes, regulations and requirements applicable to Medicaid, Medicare and other State and Federal health care programs.
• Perform other revenue cycle projects and initiatives as directed by Practice Administrator

Experience in ophthalmology billing preferred but not required. Duties and responsibilities may be added, deleted or changed at any time at the discretion of the management, formally or informally, either verbally or in writing.

Minimum Requirements

Bachelor’s Degree in healthcare administration, business administration, finance or a related field.

Minimum of 5-7 years of progressive experience in healthcare revenue cycle management, with at least 2-3 years in a leadership role.

Strong understanding of healthcare billing, coding, reimbursement and regulatory requirements

Proficiency in revenue cycle management software, electronic health records (EHR), and Microsoft Office applications.

Certified Professional Coder (CPC), Certified Revenue Cycle Professional (CRCP), or other relevant certifications preferred.

Knowledge of healthcare compliance regulations (e.g., HIPAA, Stark Law, Anti-Kickback Statute) and experience implementing compliance programs is a plus

Job Type : Full-time

Benefits :

401(k)

Dental insurance

Health insurance

Paid time off

Education :

Bachelor's (Preferred)

Experience :

Medical billing : 5 years (Required)

Ability to Commute :

New Haven, CT 06519 (Required)

Ability to Relocate :

New Haven, CT 06519 : Relocate before starting work (Required)

Work Location : In person

Company Description

Working for a physician-owned medical practice means joining a team where clinical excellence and patient care — not corporate profit — drive every decision. As a member of our Revenue Cycle team, you’ll work directly with physician leaders who are actively involved in operations and deeply committed to quality, ethics, and long-term success. This is an onsite position primarily in New Haven.

Company Description

Working for a physician-owned medical practice means joining a team where clinical excellence and patient care — not corporate profit — drive every decision. As a member of our Revenue Cycle team, you’ll work directly with physician leaders who are actively involved in operations and deeply committed to quality, ethics, and long-term success. This is an onsite position primarily in New Haven.