Revenue Cycle Manager

POSITION DESCRIPTION

The Revenue Cycle Manager (RCM) is responsible for overseeing all aspects of the revenue cycle, including patient access, coding, billing, collections, and reimbursement. This role ensures the organization maximizes revenue, maintains compliance with regulatory requirements, and delivers efficient, patient-centered financial processes. The RCM collaborates closely with clinical, finance, and operations leadership to optimize financial performance and cash flow.

ESSENTIAL DUTIES & RESPONSIBILITIES

• Oversee end-to-end revenue cycle functions: scheduling, registration, insurance verification, coding, charge capture, billing, and collections
• Ensure timely and accurate claim submission and payment posting
• Monitor and reduce denials, rejections, and write-offs
• Optimize workflows to improve clean claim rates and days in A/R
• Track and report key revenue cycle KPIs
• Ensure compliance with CMS, HIPAA, and payer regulations
• Lead, mentor, and develop billing, coding, and front-end staff
• Implement denial prevention strategies and process improvements
• Oversee revenue cycle systems (EHR/PM) optimization

REQUIRED EDUCATION, EXPERIENCE, CERTIFICATIONS AND LICENSES

• Bachelor's degree from an accredited college or institution in Healthcare Administration, Finance, Accounting, or related field, equivalent experience may be considered.
• Experience working with EHR systems: NextGen & Epic.
• Five or more years of revenue cycle management experience.
• Experience in clinic or multi-site healthcare environment
• Must have a good understanding and ability to work with the Indian communities and overall TIHP staff.
• Must be sensitive and possess an awareness and keen appreciation of Indian traditions, customs, and socioeconomic needs of the Indian community.
• Cardiopulmonary resuscitation (CPR) certified or obtain within three months of hire.

PREFERRED EDUCATION, EXPERIENCE, CERTIFICATIONS AND LICENSES

• Master's degree from an accredited college or institution in accounting, financial management or related field.
• Preferred certifications:

CRCR, CPC, CHFP SKILLS & COMPETENCIES

• Strong knowledge of billing, coding, and reimbursement
• Analytical and problem-solving skills
• Leadership and team development
• Knowledge of Medicare, Medicaid, and payer contracts
• Communication and stakeholder management
• Attention to detail and compliance focus

PHYSICAL DEMANDS

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. Sitting /

Mobility:

Approximately 80% of time is spent working at a desk. Balance of time (approximately 20%) is spent moving around work areas.

Communication:

Ability to effectively communicate with co-workers, patients, members of outside agencies, in person, by telephone, and by email.

Vision:

Ability to effectively use a computer screen and interpret printed materials, memos, and other appropriate paperwork. Lifting /

Carrying:

Ability to occasionally lift and/or move objects weighing no more than 25 pounds. Stooping /

Kneeling:

Ability to access files/stock supplies in low cabinets and shelves. Reaching /

Handling:

Ability to input information into computer systems and retrieve and work with appropriate paperwork, equipment, and supplies. Use of standard office equipment, including computer, telephone, calculator, copiers, and fax. Work is performed in an office/clinic environment; continuous contact with other staff and the public.

EMPLOYMENT INFORMATION INDIAN PREFERENCE

: Preference may be given to qualified Native American Indians according to the Indian Preference Hiring Act, CFR 25 USC 472. Other than Toiyabe Indian Health Project, Inc. adheres to all provisions of the Equal Employment Opportunities Act.

EQUAL OPPORTUNITY EMPLOYER

TIHP does not discriminate on the basis of race, color, national original, sex, religious preference, age, handicap, marital status, political preference, genetics or membership or non-membership in any employee organization, except as allowed by Federal and/or Tribal Law.

NOTICE OF DRUG-FREE WORKPLACE ACT REQUIREMENT

TIHP is committed to maintaining a drug free and alcohol free workplace. TIHP believes that a healthy, productive workforce free from the effects of drugs is very important to all employees and patients. Substance abuse is incompatible with the health, safety, efficiency and success of

TIHP. HIPAA

Health Insurance Portability and Accountability:

This act was enacted to deal with these main areas with regard to patient information. Uses and Disclosures for Treatment, Payment, and Health Care Operations (45 CFR 164.506) are also covered under this act. HIPAA

• Security of Private Health Information
• Standards of Electronic Transactions
• Privacy of individually identifiable health information
• Ready access to treatment and efficient payment for health care, both of which require use and disclosure of protected health information, are essential to the effective operation of the health care system.

In addition, certain health care operations—such as administrative, financial, legal, and quality improvement activities—conducted by or for health care providers and health plans, are essential to support treatment and payment.

DRIVING RECORD

Employees must have a valid Driver License and be insurable under THIP's vehicle insurance program.

BACKGROUND CHECKS

All employees must be able to pass a background check per Toiyabe's Background Check Policy.

Pay:

$76,148.80 - $101,628.80 per year

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Application Question(s): Do you have experience working with EHR systems: NextGen & Epic? Have experience in a clinic or multi-site healthcare

Education:

Bachelor's (Preferred)

Experience:

Revenue cycle management: 5 years (Required) Ability to

Relocate:

Bishop, CA 93514: Relocate before starting work (Required)

Work Location:

In person