REVENUE CYCLE MANAGER - Full-Time

JOB DESCRIPTION OBJECTIVE

The Revenue Cycle Manager oversees all aspects of the billing, collections, and revenue operations at Elevation Individual and Family Therapy, ensuring the financial health and sustainability of the practice. This role is responsible for developing and implementing billing policies, monitoring key financial indicators, ensuring payer compliance, and providing leadership over billing processes. This position requires a professional who combines strategic thinking with a hands-on approach, demonstrating the ability to perform day-to-day tasks directly while simultaneously leading process improvements and overseeing overall performance. The Revenue Cycle Manager serves as the point of contact for all billing-related matters, actively collaborating with leadership and administrative staff to maximize revenue and maintain smooth financial workflows. This is a hands-on leadership role where the Revenue Cycle Manager actively performs billing and credentialing tasks while also overseeing billing operations and ensuring financial health. Essential Functions and Responsibilities 1. Revenue Cycle Oversight Manage the full revenue cycle process, including insurance verification, claims submission, payment posting, denial management, and patient collections. Develop, implement, and maintain clear billing policies, procedures, and standard operating procedures to ensure consistency and compliance. Establish and monitor key performance indicators (KPIs), including but not limited to: days in A/R, clean claims rate, denial rates, collections, and net revenue. Ensure accuracy in payer billing across Medicaid, Medicare, commercial insurance, EAP programs, and private pay clients. Lead financial process improvement initiatives to reduce denials, speed up collections, and improve cash flow. Oversee the collections process, including identifying delinquent accounts, issuing final notices, and coordinating third-party collections when necessary. Oversee and manage the credentialing and re-credentialing process for therapists with insurance payers, ensuring timely submission of applications, tracking of approval status, and maintenance of up-to-date provider records. Handle and support critical revenue cycle functions, including insurance verification, claims submission, payment posting, denial resolution, patient collections, and therapist credentialing with insurance payers. 2. Billing and Financial Operations Serve as the primary liaison with the billing team or third-party billing companies for escalated issues, process optimization, and troubleshooting. Monitor and manage accounts receivable, ensuring timely follow-up on outstanding balances, underpayments, and contract payments. Oversee patient billing communications, including statements, payment plans, and financial hardship requests. Assist leadership with fee schedule reviews, payer contract considerations, and financial forecasting. 3. Compliance and Audit Support Ensure compliance with federal, state, and payer-specific billing and documentation regulations. Conduct periodic internal audits to assess billing accuracy, coding compliance, and policy adherence. Address audit findings with corrective action plans and staff training as needed. Maintain accurate and organized records of all billing-related documentation, including payer notices, contracts, and updates. Ensure accurate and current credentialing files are maintained for all therapists, aligned with payer requirements and internal policies. 4. Collaboration and Communication Provide clear and timely communication with clinical, administrative, and leadership teams regarding billing workflows, documentation requirements, and payer updates. Develop and deliver training sessions or materials for staff on billing policies and best practices. Prepare and present regular financial reports, KPI dashboards, and performance summaries to the CEO and leadership team. Respond to internal and external emails within 24-48 hours and provide effective communication to clients regarding billing inquiries. 5. Team Supervision and Leadership Directly perform key billing and revenue cycle tasks alongside the billing team, including claims submission, payment posting, denials management, collections, and credentialing. Monitor team performance to ensure goals and deadlines are met. Identify operational inefficiencies or bottlenecks and propose solutions to improve workflow. Participate in leadership meetings, supervision sessions, and organization-wide meetings as required. Provide leadership and oversight to the billing function, while maintaining an active role in daily operations. Supervise internal billing staff and coordinate with external partners (e.g., clearinghouses, payer representatives, or contracted services) as needed to support billing workflows and resolve issues. Complete additional duties as assigned by the Chief Executive Officer. Qualifications Associate's degree in Healthcare Administration, Business, Finance, or related field (Bachelor's preferred). 3+ years of experience in revenue cycle management, billing, or healthcare financial operations. Strong understanding of Medicaid, Medicare, and commercial insurance billing processes, including behavioral health and outpatient services. Proficiency with EHR and billing software, as well as Microsoft Office Suite (Excel, Word, Outlook). Exceptional organizational, analytical, and problem-solving skills. Ability to communicate effectively across clinical, administrative, and leadership teams. Skilled at interpreting financial data and creating actionable strategies. Strong leadership skills and ability to collaborate with multidisciplinary teams. Ability to lift 10-15 pounds.