Job Description
The Revenue Cycle Manager at Serenity Oaks Inpatient Rehabilitation Facility is responsible for overseeing and optimizing all aspects of the revenue cycle process for inpatient rehabilitation services. This role ensures accurate patient billing, insurance verification, coding oversight, reimbursement optimization, denial management, and regulatory compliance under
CMS IRF-PPS
guidelines and payer-specific requirements. The Revenue Cycle Manager collaborates closely with clinical leadership, Health Information Management (HIM), case management, admissions, and finance to maximize reimbursement, improve operational efficiency, reduce denials, and support the overall financial health of the organization. ESSENTIAL FUNCTIONS & RESPONSIBILITIES
Oversee all revenue cycle operations including patient registration, insurance verification, authorization management, billing, collections, payment posting, and accounts receivable follow-up. Manage and monitor inpatient rehabilitation billing processes for Medicare Part A, Medicaid, commercial insurance, managed care, and other payer sources. Ensure accurate preparation and submission of UB-04 claims in compliance with CMS IRF-PPS
requirements, payer regulations, and facility billing policies. Supervise revenue cycle staff including hiring, onboarding, training, performance management, scheduling, and ongoing competency development. Monitor claim denials, rejections, underpayments, and appeals; implement corrective action plans to improve reimbursement outcomes and reduce denial rates. Collaborate with HIM, case management, therapy, nursing, admissions, and physicians to ensure accurate documentation, coding, charge capture, and reimbursement integrity. Review revenue cycle metrics including accounts receivable aging, cash collections, denial trends, clean claim rates, days in A/R, and reimbursement variances; prepare reports for executive leadership. Maintain compliance with CMS regulations, HIPAA requirements, OIG guidance, payer contract requirements, and state and federal healthcare billing regulations. Identify operational inefficiencies, billing risks, documentation gaps, and compliance concerns; implement process improvement initiatives to optimize revenue cycle performance. Maintain current knowledge of IRF-PPS updates, Medicare billing transmittals, payer policies, LCDs, and National Coverage Determinations affecting reimbursement. Coordinate payer communications, contract discussions, authorization issues, appeals, and reimbursement disputes as needed. Serve as a resource for patient billing inquiries, financial concerns, and escalation issues related to reimbursement and insurance coverage. Participate in internal audits, compliance reviews, corrective action plans, and CARF-related financial management activities. Ensure accurate maintenance of billing records, financial documentation, and revenue cycle reporting in accordance with facility and regulatory standards. EDUCATION & EXPERIENCE REQUIREMENTS
Required:
Bachelor's degree in Healthcare Administration, Business Administration, Finance, Health Information Management, or related field preferred. Required:
Minimum four (4) years of progressive revenue cycle management experience in a hospital, inpatient rehabilitation facility, acute care, or healthcare setting. Required:
Strong working knowledge of IRF-PPS reimbursement methodology, Medicare Part A billing, UB-04 claim processing, accounts receivable management, and denial resolution. Preferred:
Previous leadership or supervisory experience within healthcare revenue cycle operations. LICENSURE, CERTIFICATION & REGISTRATION REQUIREMENTS
Preferred:
Certified Professional Biller (CPB), Certified Revenue Cycle Representative (CRCR), Certified Coding Specialist (CCS), RHIT, RHIA, or related healthcare revenue cycle certification. Preferred:
Knowledge of ICD-10-CM/PCS
coding and rehabilitation reimbursement methodologies. KNOWLEDGE, SKILLS & ABILITIES
Advanced knowledge of healthcare revenue cycle operations, inpatient rehabilitation reimbursement, and Medicare billing requirements. Strong understanding of IRF-PPS reimbursement methodologies, CMG assignment, payer guidelines, and medical necessity requirements. Proficiency with EHR systems, healthcare billing software, clearinghouse systems, and revenue cycle reporting tools. Strong analytical skills with the ability to evaluate financial data, identify trends, and implement operational improvements. Ability to effectively manage denials, appeals, underpayments, and payer disputes. Strong leadership, organizational, problem-solving, and decision-making abilities. Excellent verbal and written communication skills with the ability to collaborate effectively across departments. Ability to maintain confidentiality and handle sensitive financial and patient information in compliance with HIPAA requirements. Strong attention to detail and ability to manage multiple priorities in a fast-paced healthcare environment. Application Question(s): Do you have a minimum four (4) years of progressive revenue cycle management experience in a hospital, inpatient rehabilitation facility, acute care, or healthcare setting Do you have a bachelor's degree in Healthcare Administration, Business Administration, Finance, Health Information Management Work Location:
In person
