Manager, Revenue Cycle Hospital Billing

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.

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.

Education:

• Bachelor's degree in healthcare administration, Business, Accounting, or related field required.
• Master's degree (MHA, MBA, or equivalent) preferred.

Experience:

• Minimum of 5 years of progressive experience in healthcare revenue cycle operations, including 2-3 years in a leadership role.
• Strong experience with EMR and billing systems;
  Epic preferred.

Knowledge, Skills, and Abilities:

• In-depth knowledge of healthcare reimbursement, payer contracts, and compliance regulations.
• Strong analytical and financial management skills.
• Excellent leadership, communication, and problem-solving abilities.
• Proven ability to manage change, motivate staff, and build cross-functional relationships.
• Commitment to patient-centered service and continuous process improvement.

• Reduction in AR days and denials.
• Improvement in net collection rate and cash flow.
• Achievement of clean claim rate and billing accuracy targets.
• Positive staff engagement and retention.
• Compliance with internal and external audit standards.
• Enhanced patient satisfaction related to billing and financial transparency.

Office-based leadership position with collaboration across hospital and outpatient sites.

Occasional travel between facilities or clinics may be required.

May require extended hours during budget, audit, or project periods.