Revenue Cycle Management Manager

Revenue Cycle Management Manager

Location: Mid-Atlantic Region
Job Type: Full-Time
Reports To: Director of Billing and Credentialing

Position Summary

Bloom Health Centers is seeking a highly organized detail-oriented and experienced Revenue Cycle Management Manager to oversee the day-to-day operations of our medical billing and coding department. This position plays a critical role in ensuring accurate and timely billing optimizing revenue cycle performance maintaining regulatory compliance and supporting strong relationships with patients providers payers and internal teams.

The Revenue Cycle Management Manager will serve as the departments subject matter expert for medical billing and coding processes while providing leadership and direction to Billing Specialists and other billing personnel. This individual will oversee the full billing cycle including coding charge entry claims submission payment posting accounts receivable follow-up denials and appeals and reimbursement management.

The ideal candidate is a proactive problem-solver who can work independently make sound decisions identify opportunities for process improvement and collaborate effectively with company leadership to implement initiatives that improve operational efficiency and cash flow.

Essential Duties & Responsibilities

Billing & Revenue Cycle Operations

• Oversee the daily operations of the billing department including medical coding charge entry claims submission payment posting accounts receivable follow-up collections and reimbursement management.
• Serve as the departments primary resource and subject matter expert for medical billing and coding processes.
• Review billing and claims for accuracy completeness and compliance prior to submission.
• Submit claims to the appropriate insurance payers and monitor claims throughout the reimbursement process.
• Follow up on outstanding denied rejected and underpaid claims using practice management systems clearinghouses payer portals and other applicable systems.
• Prepare and submit appeals and other documentation as needed to support appropriate reimbursement.
• Monitor accounts receivable and identify trends or issues that may negatively impact collections and cash flow.
• Develop and implement strategies to improve collection rates reduce outstanding receivables and minimize billing errors and denials.
• Maintain accurate and timely patient insurance and billing documentation.
• Collaborate with other departments to obtain and verify information necessary for accurate billing and claims processing.

Leadership & Staff Management

• Supervise and provide day-to-day leadership to Billing Specialists and other billing department personnel.
• Assign and prioritize workloads to ensure department responsibilities are completed accurately and within established timelines.
• Train coach and support billing staff to promote productivity accountability and professional development.
• Coordinate onboarding and ongoing training for new and existing team members on billing systems policies procedures payer requirements and coding standards.
• Serve as a resource for staff questions and assist with resolving complex billing and coding issues.
• Coordinate team member schedules and time off to maintain appropriate department coverage and ensure continuity of daily operations.
• Promote a collaborative professional and high-performing team environment.

Compliance Coding & Credentialing

• Ensure billing and coding practices comply with applicable federal and state regulations payer requirements and organizational policies.
• Stay current on changes to medical billing coding reimbursement and payer regulations and communicate relevant updates to staff and leadership.
• Maintain current resources and reference materials related to coding documentation billing and regulatory requirements.
• Review and update department procedures as needed to maintain compliance and operational effectiveness.
• Perform and/or coordinate physician credentialing activities as assigned.
• Identify compliance risks and recommend corrective actions when necessary.

Reporting & Performance Management

• Prepare and present detailed billing accounts receivable reimbursement and other financial activity reports.
• Prepare and analyze weekly and monthly billing and financial reports in collaboration with the Practice Administrator Business Manager and COO.
• Compile and maintain accurate billing and revenue cycle statistics and performance metrics.
• Monitor departmental performance and identify trends affecting charges coding collections denials and accounts receivable.
• Make recommendations regarding staffing workflow policies and procedures based on operational data and department performance.
• Provide leadership with timely updates regarding billing performance challenges opportunities and areas requiring attention.

Process Improvement & Strategic Support

• Regularly evaluate billing and collection procedures to identify opportunities to improve efficiency accuracy and revenue cycle performance.
• Participate in the development and implementation of billing department policies procedures and operational initiatives.
• Analyze workflow and operational data to identify inefficiencies eliminate redundancy and improve processes.
• Assist company leadership with the implementation of new systems processes and initiatives designed to improve revenue and operational efficiency.
• Make independent decisions within the scope of the position and escalate significant issues to the COO when appropriate.
• Perform other duties and responsibilities as assigned by the COO.

Position Requirements

Education & Experience

• Associate degree in Business Administration Healthcare Administration Medical Billing or a related field preferred.
• Bachelors degree preferred.
• Current medical coding certification required.
• Minimum of 3 years of experience in medical billing insurance revenue cycle management or healthcare collections within a medical practice behavioral health organization or health system.
• Strong understanding of medical billing coding insurance claims reimbursement accounts receivable and applicable regulatory requirements.
• Minimum of 2 years of supervisory or management experience preferred.
• Equivalent combinations of education and relevant experience may be considered.

Communication Skills

• Strong written and verbal communication skills with the ability to communicate effectively with physicians patients insurance carriers employees leadership government entities and other stakeholders.
• Ability to read analyze and interpret professional publications business documents accounting information and governmental regulations.
• Ability to prepare clear and professional reports business correspondence procedures and other documentation.
• Ability to confidently present information and respond to questions from employees managers physicians payers government entities and the general public.
• Strong interpersonal skills and the ability to build and maintain effective working relationships across departments.

Job-Specific Skills & Competencies

• Strong knowledge of medical billing coding claims processing reimbursement and accounts receivable management.
• Exceptional attention to detail and commitment to accuracy.
• Strong analytical and problem-solving skills with the ability to identify errors determine root causes and implement effective solutions.
• Ability to recognize opportunities for process improvement and develop workflows that increase efficiency and reduce redundancy.
• Ability to work independently with minimal supervision while demonstrating sound judgment and initiative.
• Strong organizational skills with the ability to prioritize multiple responsibilities and meet deadlines.
• Ability to supervise train coach and motivate employees.
• Ability to effectively organize prioritize and delegate work assignments.
• Ability to make timely and accurate decisions related to billing accounts receivable claims and departmental operations.
• Ability to manage competing priorities in a fast-paced environment while maintaining accuracy and professionalism.
• Ability to conceptualize workflows develop action plans and successfully implement process improvements.
• Ability to establish and maintain effective working relationships with employees patients providers insurance companies and other external partners.
• Comfortable working in an environment with frequent interruptions and changing priorities.
• Proficiency with Microsoft Office including Outlook Word and Excel.
• Experience with electronic medical records (EMR) practice management systems clearinghouses and payer portals preferred.

Physical Requirements & Work Environment

While performing the essential functions of this position the employee is regularly required to communicate verbally and listen effectively. The position requires extended periods of sitting and frequent use of hands and fingers for typing and other computer-related tasks.

The employee may occasionally be required to stand walk reach bend stoop kneel crouch or crawl. The employee may be required to lift and carry items weighing up to 25 pounds.

Specific vision requirements include the ability to view computer screens and printed materials with sufficient near and distance vision peripheral vision depth perception and ability to adjust focus.

The noise level in the work environment is generally moderate.

Why Join Bloom Health Centers

This is an excellent opportunity for an experienced billing professional to take a leadership role within a growing healthcare organization. The Revenue Cycle Management Manager will have the opportunity to directly influence revenue cycle performance develop and support a billing team improve operational processes and collaborate with organizational leadership on initiatives that support the continued growth of Bloom Health Centers.