Manager, Revenue Cycle Hospital Billing (1991)
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Overview
Job Description
Position Summary:
The Manager of Revenue Cycle HB is responsible for overseeing and coordinating all aspects of the healthcare organization's revenue cycle operations to ensure accurate, timely, and compliant billing, collections, and reimbursement processes. This position provides leadership to Business Services/Accounts Receivable, with a focus on optimizing cash flow, reducing denials, and enhancing the patient financial experience.
The role combines operational management with strategic oversight to drive continuous improvement and ensure alignment with organizational goals and compliance standards.
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Essential Duties and Responsibilities
HB Revenue Cycle Operations
Direct and oversee daily operations across Business Services/Accounts Receivable areas.
Ensure accurate and timely claims submission, payment posting, and account resolution.
Monitor key performance indicators (KPIs) such as AR days, denial rates, clean claim rate, cash collections, and bad debt.
Coordinate workflow between departments to ensure smooth handoffs and prevent revenue leakage.
Ensure adherence to payer requirements, federal/state billing regulations, and internal policies.
Leadership and Staff Development
Supervise, coach, and develop revenue cycle staff, fostering a culture of accountability and excellence.
Establish clear performance expectations and conduct regular evaluations.
Provide training on system updates, compliance standards, and payer policy changes.
Lead by example to promote teamwork, transparency, and continuous improvement.
Financial and Performance Management
Analyze revenue cycle data to identify trends, inefficiencies, and opportunities for process improvement.
Partner with Finance to reconcile revenue, forecast cash flow, and ensure accuracy in reporting.
Develop and manage departmental budgets, ensuring cost-effective operations.
Lead initiatives to improve reimbursement, reduce denials, and enhance overall revenue integrity.
Compliance and Quality
Ensure compliance with HIPAA, CMS, and payer regulations.
Collaborate with Compliance and Legal teams to monitor internal audits and respond to external reviews.
Implement corrective actions as needed and maintain accurate records and documentation.
Technology and Process Optimization
Work with Information Systems to optimize EMR and billing platforms (e.g., Epic).
Evaluate and implement tools that enhance automation, analytics, and reporting.
Lead or support system upgrades and workflow improvement initiatives.
Collaboration and Communication
Serve as the primary liaison between clinical departments, Finance, and external payers on revenue cycle matters.
Collaborate with department leaders to ensure accurate documentation, coding, and charge capture.
Communicate key revenue cycle metrics and improvement initiatives to senior leadership.
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Submit 10x as many applications with less effort than one manual application.