Description

Position Title: Revenue Cycle Manager

Department: Finance / Revenue Cycle / Behavioral Health Administration

Reports to: Chief Financial Officer / Senior Vice President / Director of Finance

Why This Role Matters

The Revenue Cycle Manager is essential to ensuring the organization is paid accurately and timely for services delivered. This role helps protect financial sustainability, strengthens internal controls, improves billing outcomes, and supports a culture where strong documentation, compliance, and operational discipline directly contribute to the mission.

Position Summary:

The Revenue Cycle Manager is responsible for the overall leadership, coordination, and performance of the organization’s revenue cycle operations. This role oversees processes related to billing, claims submission, payment posting, denial management, accounts receivable follow up, credentialing coordination, and compliance with payer, regulatory, and organizational requirements.
This position works closely with program leadership, finance, quality, and clinical teams to ensure timely, accurate, and audit defensible billing practices that maximize reimbursement, reduce revenue leakage, and support the organization’s financial sustainability.

Essential Responsibilities:

Revenue Cycle Operations

• Oversee day to day revenue cycle functions including charge capture, claim generation, claim submission, payment posting, denial management, collections, and accounts receivable follow up.
• Monitor billing workflows to ensure claims are submitted timely, accurately, and in accordance with payer requirements.
• Identify trends that negatively impact cash flow, reimbursement, or billing productivity and implement corrective action plans.
• Lead the resolution of held claims, denials, rejected claims, underpayments, and aging accounts receivable.
• Ensure coordination across internal teams and external vendors involved in billing, clearinghouse activity, and collections.

Performance Management and Oversight

• Develop and track key revenue cycle metrics including clean claim rate, denial rate, days in accounts receivable, cash collections, aging, held claims, write offs, and payment turnaround times.
• Produce routine revenue cycle reports, dashboards, and summaries for senior leadership.
• Analyze financial and operational data to identify barriers, process gaps, and opportunities for improvement.
• Establish performance expectations and accountability measures for staff and vendors supporting the revenue cycle process.
• Monitor payer trends and changes that may affect reimbursement, authorizations, billing requirements, or compliance.

Compliance and Quality Control

• Ensure billing practices are compliant with all applicable federal, state, Medicaid, managed care, and payer regulations.
• Partner with Quality Improvement, Clinical Leadership, and Finance to support documentation standards that are audit defensible and aligned with billed services.
• Conduct regular audits of billing workflows, claims activity, and supporting documentation to ensure accuracy and reduce compliance risk.
• Collaborate with leadership to develop and implement standard operating procedures, internal controls, and training related to revenue cycle functions.
• Support organizational readiness for audits, site visits, and payer reviews.

Cross Functional Collaboration

• Partner with program leaders, supervisors, clinicians, and finance staff to improve documentation, coding accuracy, productivity, and billing outcomes.
• Work closely with Electronic Health Record and billing system users to optimize workflows and reduce manual errors.
• Serve as a liaison with external billing vendors, clearinghouses, Medicaid consultants, managed care entities, and payers.
• Collaborate with credentialing, contracting, utilization review, and authorizations staff to strengthen reimbursement processes from intake through payment.

Leadership and Staff Development

• Supervise revenue cycle staff and support a culture of accountability, urgency, accuracy, and customer service.
• Provide coaching, guidance, and ongoing training to staff related to claims management, billing compliance, payer updates, and best practices.
• Assist with recruiting, onboarding, and evaluating revenue cycle team members.
• Promote strong communication and collaboration between finance, operations, and clinical teams.

Education/Job Experience/Certifications:

• Bachelor’s degree in Healthcare Administration, Finance, Business Administration, Accounting, or a related field required. Master’s degree preferred.
• Minimum of 5 years of progressive experience in revenue cycle, medical billing, healthcare finance, or a related field required.
• Minimum of 2 years of management or supervisory experience preferred.
• Experience working with Medicaid, managed care, commercial insurance, and government payers strongly preferred.
• Experience in behavioral health, social services, community mental health, child welfare, or nonprofit healthcare settings strongly preferred.
• Familiarity with Electronic Health Records, billing software, clearinghouses, and revenue cycle reporting systems required.
• Experience with regulatory audits, documentation compliance, and payer billing requirements preferred.

Special Knowledge and Qualifications:

• Strong understanding of end to end revenue cycle operations.
• Strong analytical, organizational, and problem solving skills.
• Ability to interpret financial, billing, and operational data and translate it into action.
• Ability to manage multiple priorities and meet deadlines in a fast paced environment.
• Excellent written and verbal communication skills.
• Strong attention to detail with a high level of accuracy and integrity.
• Ability to lead teams, influence cross functional partners, and drive process improvement.
• Ability to maintain confidentiality and exercise sound judgment.
• Experience with behavioral health billing under Medicaid or Rule 132 type environments.
• Experience managing third party billing vendors or consultants.
• Experience developing dashboards, SOPs, workflow maps, and revenue cycle performance plans.
• Knowledge of credentialing, payer enrollment, and authorization workflows.
• Experience with audit preparation and corrective action planning.
   

Core Competencies

• Leadership    
• Accountability    
• Financial Stewardship
• Regulatory Compliance
• Process Improvement    
• Collaboration
• Data Driven Decision Making
• Communication
• Problem Solving

Working Conditions: Primarily office based with prolonged periods of sitting, computer work, and participation in meetings. May require occasional travel between program sites. May require additional hours during month end close, audit periods, or major billing initiatives.