Manager of Clinical Revenue Operations Cycle

The Manager of Clinical Revenue Operations Cycle is a full-time 12-month position that is responsible for overseeing the comprehensive revenue cycle management process for clinical programs within the university. This role ensures optimal financial performance through strategic planning operational excellence and regulatory compliance while supporting the universitys academic mission and development goals.

The position reports to the VP of Financial Affairs and University Development and oversees the revenue cycle operations payor credentialing and patient accounts team. This role will also work closely with the leadership of HPU Health including the HPU Health Managers.

QUALIFICATIONS

Education

• Bachelors degree in Business Administration Finance Healthcare Administration or related field
• Preferred- either a Masters Degree in Health Sciences/related field or Masters Degree in Business/Healthcare administration

Experience and Training

• 5-7 years of progressive experience in healthcare revenue cycle management across multiple clinical disciplines
• 3 years of supervisory or management experience
• Experience in dental revenue cycle operations payor credentialing and patient accounts in multi-group settings
• Knowledge of academic medical center operations preferred
• Strong knowledge in contract negotiations healthcare finance and accounting

Knowledge Skills Ability:

• Proficiency in EPIC revenue cycle management software and electronic health records systems
• Advanced knowledge of Microsoft Office Suite particularly Excel for financial analysis
• Understanding of dental practice management systems
• Experience with data analysis tools and reporting platforms
• Robust verbal and written communication skills
• Comprehensive understanding of clinical coding and billing procedures
• Knowledge of insurance regulations Medicare Medicaid and commercial payer requirements across clinical disciplines
• Familiarity with HIPAA and other healthcare compliance regulations
• Understanding of fee schedule development and management for various clinical services
• Knowledge of collection laws and patient financial assistance programs

ESSENTIAL FUNCTIONS

The candidate will be expected to perform the following duties including but not limited to:

Strategic Revenue Management

• Develops and implements revenue cycle strategies processes and improvement initiatives across all clinical programs to maximize billings and collections to ensure institutional sustainability
• Analyzes revenue cycle data to identify trends discrepancies and opportunities for financial improvement across multiple clinical disciplines
• Designs and maintains fee schedules to optimize revenue and reduce claim denials
• Establishes and monitors key performance indicators including Days in Accounts Receivable (DAR) claim denial rates and collection rates across all clinical services
• Creates comprehensive financial reports and present findings to senior leadership

Operational Oversight

• Directs daily operational activities for end-to-end revenue cycle performance across all clinical services
• Ensures billing practices align with healthcare regulations and standards including accurate coding documentation and charge capture for each clinical discipline
• Develops efficient process workflows and production team assignments to maximize operational effectiveness across multiple clinical areas
• Manages patient billing cycles for all clinical services
• Oversees insurance verification pre-authorization processes and claims submission procedures for various clinical specialties
• Responsible for collecting evaluating and presenting operational data and performance analytics to the Chief Dental Officer and Executive Leadership Team.

Compliance and Regulatory Management

• Ensures adherence to all federal state and local healthcare regulations including HIPAA compliance
• Monitors and responds to legislative and regulatory billing changes affecting dental revenue operations
• Maintains expertise in coding standards across clinical disciplines (CDT for dental CPT for optometry etc.) and respective insurance regulations
• Conducts regular audits to ensure compliance with payer rules and internal policies across all clinical programs

Team Leadership and Development

• Supervises and manages revenue cycle staff including billing specialists collections personnel and administrative support
• Provides ongoing education and training to staff on coding documentation rules regulations and best practices across multiple clinical disciplines
• Builds and designs high-performance management infrastructure to support organizational growth
• Conducts performance evaluations and implement professional development plans
• Fosters a collaborative team environment focused on continuous improvement

Stakeholder Collaboration

• Works closely with clinical operations compliance and academic departments to ensures seamless revenue processes
• Serves as primary liaison with third-party billing partners and insurance companies
• Collaborates with university development office on financial planning and reporting
• Partners with academic leadership to support educational and research missions
• Communicates revenue cycle performance and issues to senior management

Financial Analysis and Reporting

• Maintains data integrity in all revenue cycle reporting systems
• Prepares monthly quarterly and annual financial performance reports
• Identifies and resolves billing discrepancies and collection issues
• Monitors cash flow patterns and implement strategies to accelerate collections
• Provides financial analysis to support strategic decision-making

ACCOUNTABILITY

• VP of Financial Affairs and University Development
• Evaluation: Ongoing performance reviews is conducted along with an annual assessment by the HPU Health Managers and includes input from clinical and academic operations.

For more information about this position please contact Brian Shollenberger Assistant Vice President for Accounting at