REVENUE CYCLE MANAGER - HYBRID

Revenue Cycle Manager - Hybrid

The Manager of Revenue Cycle is responsible for supporting and monitoring the acute and physician revenue cycle operations. The Manager will work closely with the Director of Revenue Cycle, Lead Revenue Cycle Analyst and RCM vendor(s) to identify opportunities, challenges, and deficiencies and escalate issues timely for optimal revenue realization. In addition, the Manager will provide direct oversight of the Acute credentialing and Ambulatory manual charge entry as well provide leadership to the Contract Management team. The manager must work effectively within a multi-layered organization, working with service line, finance, and revenue cycle leaders to achieve performance objectives.

Essential Job Functions

• Continuously monitors and assesses Revenue Cycle Management (RCM) performance to ensure financial goals are met, including metrics such as accounts receivable (AR) days, AR aging, administrative write-offs, charge lag and reconciliation, denials, and underpayments.
• Provides leadership to the Contract Management team to facilitate new contract initiatives and monitor contract milestones. Additionally, partners with the Contract Management vendor to ensure contracts are uploaded promptly and with precision. Works with team to regularly evaluate contracted reimbursement rates against actual payments and addresses any inconsistencies that arise.
• Manages Single Case Agreement process in collaboration with Contract Management, RCM vendor and Service Line Leaders.
• Manages ambulatory manual charge processing for external IHS providers.
• Manages all aspects of the Acute credentialing process. Reviews and troubleshoots monthly health plan nonparticipation denials.
• Supports change management initiatives connected with process modifications or regulatory changes that affect workflows and billing practices. Collaborates with relevant departments and external partners to facilitate a smooth transition and minimize any disruptions to operations.
• Delivers specialized support and guidance to both internal teams and external clients, addressing complex revenue cycle issues and ensuring high-quality customer service and compliance. Exercises sound judgment when making decisions that influence patients, payers and the broader health system, weighing potential outcomes to promote financial health and operational efficiency.
• Maintains collaborative and productive working relationships with all revenue cycle, service line, and finance leaders to support alignment on business objectives and the achievement of key performance benchmarks. Proactively communicates and partners with cross-functional teams to identify needs, address challenges, and implement effective strategies that drive operational excellence and financial success across the organization.
• Maintains and cultivates relationships with health plan leaders and participates in health system JOC meetings.
• Reviews and updates revenue cycle policies and procedures.
• Other duties as assigned.

Competency and Experience [Knowledge, Skills and Abilities]

Required Qualifications / Experience

Preferred Qualifications / Experience

License, Certification & Clearances

Position Type / Expected Hours of Work

Equal Employment Opportunity

Independence Health and its affiliated companies are Equal Opportunity Employers. It is their policy to prohibit discrimination of any type and to afford equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, marital status, disability, veteran status, or genetic information, or any other classification protected by law. Independence Health and its affiliated companies will comply with all applicable laws and regulations.

Disclaimer

This job description is not designed to contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee. Moreover, duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

Work Environment

Effective March 2020 or during pandemic : goggles, face shield and mask are required according to CDC guidelines