Revenue Cycle Manager

Revenue Cycle Manager

Hours per week: Full time at 32 hours per week*

Note: As of June 23, 2025, Full-Time employment is 32 hours per week for an organizational wide pilot.*

Primary location: Winters, CA

We are on the lookout for an experienced Revenue Cycle Manager to join our team!

If you are viewing this posting on an external recruitment website, please visit and apply directly on our careers page at: https://wintershealth.bamboohr.com/careers/122?source=aWQ9MTc%3D

As the Revenue Cycle Manager at Winters Healthcare, if you were in this role, you would be the subject matter expert on all things billing, coding, credentialing, and the full revenue cycle within a Federally Qualified Health Center (FQHC). Reporting directly to the Director of Finance, you will oversee the revenue cycle team, including a billing team of two, and a medical front office team of five Patient Service Representatives (PSR). This position plays a critical role in bridging the front and back office, ensuring alighment between patient access, registration, billing, and collections. You will also work closely with providers, department managers, HR, and leadership to maintain efficient, compliance, and patient centered revenue cycle operations.

Your day-to-day will have varying functions such as reviewing and submitting claims, resolving denials, and ensuring clean billing across medical, dental, behavioral health, and pharmacy services. If you were in this role, you would support the billing and PSR teams with complex issues, resolving patient billing issues in a professional and courteous manner, and support organizational initiatives that improve the performance of the revenue cycle and AR. You will be responsible for initiating training and mentorship for your direct team, as well as for providers organization wide. Other important pieces include billing and coding efficiencies, EHR optimization (Ochin Epic) in conjunction with our Medical and Dental Director and Department managers, as well as perform occasional internal audits for ensuring regulation compliance.

You will also play a critical role in credentialing by partnering with the HR team and incoming providers, as well as our board of directors (for CMS application), to complete payer applications and ensure contracts are current and compliant. Beyond daily billing operations, you will collaborate with the Director of Finance on Sliding Fee Scale (SFS) oversight and support organizational initiatives that improve financial health and operational efficiency.

This role is ideal for someone with proven expertise in billing and coding, revenue cycle management and credentialing. Additionally, strong leadership skills, a collaborative mindset, and a passion for leveraging technology and training to strengthen both team performance and patient access to care, and building effective cross-functional partnerships is essential.

Essential Functions:

• Oversee and manage the full revenue cycle, including front-office (registration, scheduling, insurance verification) and back-office (charge posting, claim submission, payment posting, denial management, and collections) functions.
• Supervise, mentor, and support a team of 2 billers and 5 Patient Service Representatives (PSRs); provide training and development opportunities for staff and providers to strengthen revenue cycle workflows.
• Develop, implement, and monitor policies and procedures to ensure compliance, efficiency, and accuracy across the revenue cycle; promote a culture of collaboration, accountability, and continuous improvement.
• Link front- and back-office functions to create seamless processes for patients, providers, and payers; respond to billing inquiries and resolve complex issues in a professional manner.
• Manage payer contracts and oversee all aspects of provider credentialing and re-credentialing (commercial, government, HRSA/BPHC); maintain accurate databases and records.
• Coordinate with billing teams, providers, and department managers to resolve denials or authorization issues; monitor regulatory changes (PPS, APM, payer requirements) to ensure compliance.
• Partner with medical and dental leadership to optimize billing, coding, and credentialing workflows in OCHIN Epic; support cross-departmental initiatives to improve financial and operational performance.

Qualifications:

• Associate's degree and/or Billing and Coding certification
• Minimum of 3 years' experience in medical and/or dental billing within a health center, including insurance contracting and provider credentialing
• Proficiency in CPT, HCPCS, and ICD-10 coding systems, with strong knowledge of Medicare, Medi-Cal, Denti-Cal, commercial insurance plans, PPS, APM, and FQHC program requirements
• Strong leadership, collaboration, communication, and problem-solving skills.
• Experience leading billing, coding, collections, and front-office operations across multiple service lines (medical, dental, behavioral health, pharmacy).
• Skilled in electronic health records (OCHIN Epic preferred) and billing systems
• Bilingual in Spanish (speak, read, write) preferred

Compensation and Benefits:

• Effective June 23, 2025 annual equivalent salary range is $73,000 - $93,400 for 32 hrs/week* and depends on experience and qualifications.
• Paid Time Off, holidays, Wellness Days (1 per week during pilot)
• Medical, dental, vision, life insurance- 90% paid for employees, and 50% paid for dependents.
• 401K retirement match program- 3% match

Hours:

• 32 hours / week with a tentative schedule of Tuesday-Friday 8am- 5:00pm (open to earlier or later start).
• We are also open to part-time candidates. Note: working 24 hours or more/ week qualifies for full health insurance benefits.
• Beginning June 23, 2025, Winters Healthcare will launch an organization-wide pilot program, redefining full-time status as 32 hours per week.*

Location:

• Winters, CA
• 1 day/ week preferred at our Esparto facility

Full job description below:

Summary of Duties:

The Billing Manager, under the general supervision of the Director of Finance, is responsible for the oversight and effectiveness of the organization's billing, coding, and credentialing functions. This position ensures timely and accurate claim processing, training of billing staff and employees, provider credentialing and re-credentialing, management of insurance contracts, and regulatory compliance. The Billing Manager takes a proactive approach in staying up to date on industry trends, health center program regulations, payer requirements, and overall billing and coding compliance.

As the billing manager, you are responsible for managing and overseeing the billing department. You are to ensure appropriate contracts are up to date with private and public insurance payers, while also acting as a resource for staff and patients with regards to questions on billing for services and insurance coverage. You will participate in the development and implementation of financial and billing policies and procedures, and perform occasional billing audits to monitor, improve efficiency and maintain compliance of billing processes. In addition, as a medical and dental biller, employee is responsible for collecting, posting, and managing account payments as well as submitting claims and following up with insurance payers, patients, and state, federal and county managed plans.

Essential Functions:

Billing & Revenue Cycle Management

• Oversee and manage the full revenue cycle, including front-office (registration, scheduling, insurance verification) and back-office (charge posting, claim submission, payment posting, denial management, and collections) functions.
• Lead the full billing cycle, including charge posting, claim submission, payment posting, follow-up, denial management, and collections.
• Monitor contracts with private and public payers to ensure accuracy and compliance.
• Respond to billing questions from patients, staff, and insurance companies; resolve complaints and complex issues in a professional and courteous manner.
• Review accounts for potential collections and make recommendations to Director of Finance.
• When applicable, review and manage delinquent accounts, establishing payment plan when necessary.
• Conduct periodic billing audits to monitor compliance, improve efficiency, and support quality improvement efforts.
• Prepare and submit regular billing and productivity reports.
• Ensure sliding fees are followed and calculated annually
• Works with billing staff to enter contracted rates into the billing system.
• Reviews contracts to ensure contract fees are entered correctly.

Credentialing, Contracting, & Compliance

• Manage all aspects of provider and organizational credentialing and re-credentialing for medical, dental, behavioral health, and pharmacy providers in accordance with HRSA/BPHC/CMS requirements and payer standards.
• Process and complete credentialing requests for commercial and government payers.
• Maintain up-to-date provider database, credentialing files, and related records.
• Coordinate with billing team, providers, department managers and leads to resolve denials or authorization issues related to provider credentials.
• Monitor changes in legislation, payer requirements, and industry standards; ensure compliance with regulatory frameworks such as PPS and APM.
• Manage and maintain contracts and applications with insurance companies and government payers.

Leadership & Team Development

• Supervise, mentor, and support a team of 2 billers and 5 Patient Service Representatives (PSRs).
• Provide ongoing training and development opportunities for staff and providers to strengthen knowledge of revenue cycle workflows.
• Develop, implement, and monitor policies and procedures that promote compliance, efficiency, and accountability.
• Foster a culture of collaboration, continuous improvement, and service excellence.
• Promote a culture of collaboration, accountability, and continuous improvement.
• Act as a liaison across departments, providers, and external agencies to ensure effective communication and resolution of billing and credentialing matters.
• Support organizational quality improvement, performance improvement initiatives, and participate in related interagency meetings and projects.
• Collaborate with the Director of Finance to review and refine policies and procedures to ensure the effectiveness of the revenue cycle/AR.
• Partner with department leaders to optimize billing, coding, and credentialing workflows in OCHIN Epic.
• Support cross-departmental initiatives to enhance workflows and financial and operational performance.
• Conduct internal audits of claims, credentialing files, and SFS processes to ensure accuracy and compliance.

Other Duties

• Support staff with project-based work and administrative tasks as assigned.
• Participate in continuing education, professional development, and required staff meetings.
• Uphold patient confidentiality and ensure compliance with HIPAA and organizational policies.
• Join and attend CPCA Billing Manager Peer Network meetings
• Other duties as assigned
• HRSA: Health Resources & Services Administration; BPHC: Bureau of Primary Health Care

Minimum Requirements:

Education and Work Experience

• Associates Degree from an accredited university, and/or Billing and Coding certification
• Three years of experience as Revenue Cycle Manager, with medical and dental billing experience in a health center,
• Experience with insurance contracting and provider credentialing (CVO experience is a plus)
• Working knowledge of CPT, HCPCS, & ICD-10 coding systems; HRSA and FQHC program and credentialing requirements; or
• Any similar combination of education and experience

Knowledge, Skills and Abilities:

• Fluency in Spanish (speak, read, and write) is a plus!
• Strong knowledge of Medicare, Medi-Cal, Denti-Cal, and commercial insurance plans.
• Proficiency with electronic health records (OCHIN Epic preferred), medical/dental coding, and billing systems.
• Ability to collaborate and create cohesion amongst cross-departmental teams.
• Understanding of FQHC regulations, encounter rates, and payment systems.
• Demonstrated ability to lead billing, coding, and collections operations across multiple service lines (medical, dental, behavioral health, pharmacy).
• Exceptional leadership, communication, and problem-solving skills.
• Strong organizational and critical thinking abilities; detail-oriented with high emotional intelligence.
• Proficiency in Microsoft Office Suite and health information technology (Epic, eClinicalWorks, Open Dental).
• Demonstrated ability to build effective relationships with patients, staff, and external partners.
• Commitment to confidentiality, HIPAA compliance, and ethical best practices.

Other Requirements:

• Authorization and consent for Winters Healthcare to investigate candidate's background with a consumer report for employment purposes, to evaluate candidate/ employee for employment, promotion, reassignment, or retention as an employee

Additional Desired Qualifications:

• Strong interest in Health Information Technology and ability to master OCHIN Epic EHR and associated reporting software.
• Proven leadership skills with strong collaborative and teaching skills with staff and patients
• Previous experience with Federally Qualified Health Centers (FQHC), low income or medically underserved populations preferred

Physical Demands:

While performing the duties and tasks of this job, the employee is regularly required to stand; walk; work on irregular surfaces; reach with hands and arms; use hands to finger, handle or feel objects, tools, or controls; talk or hear; and taste or smell. The employee is occasionally required to sit and stoop, kneel, crouch, bend, squat, twist or crawl. This job requires physical effort and the ability to place or retrieve items at below waist level may be required.

The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision and depth perception, and the ability to adjust focus. The employee occasionally may be required to transfer patients to and from a wheelchair.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Environmental/ Working Conditions:

The environment is a standard office environment. Regular office hours are Monday through Friday. Occasionally, evenings, weekends and overtime may be required. Office hours may be changed as business needs dictate. The working environment characteristics described here are representative of those an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.

While performing the duties of this job, the employee is occasionally exposed to toxic or caustic chemicals, required to work near moving mechanical parts and sharp instruments, and may be at risk of electrical shock. The noise level in the work environment is usually moderate.

Operating hours:

• Monday, Tuesday, and Thursday: 8:00 am- 8:00pm, and Wednesday and Friday: 8:00 am- 5:00 pm

Hours:

• This position is 32 hours per week with a proposed schedule of Tuesday- Friday 8:00 am to 5:00 pm; occasional evenings may be required, and 1-2 additional evenings throughout the year to attend the Board of Directors meeting as requested. Actual working hours may vary.