Revenue Cycle Manager

Position Summary

The Revenue Cycle Manager is responsible for overseeing and optimizing all aspects of the revenue cycle for Health Care Partners of South Carolina (HCPSC). This role ensures accurate patient registration, coding, billing, collections, and compliance with federal, state, and payer-specific regulations. The Revenue Cycle Manager will lead billing and coding professionals, collaborate with clinical and administrative staff, and implement strategies to maximize reimbursement while maintaining a patient-centered approach.

Essential Duties and Responsibilities

•Lead and manage the end-to-end revenue cycle process, including patient intake, insurance verification, coding, billing, payment posting, and collections.

•Supervise and mentor billing and coding staff, providing training, performance feedback, and professional development opportunities.

•Monitor and analyze key performance indicators (KPIs) such as days in accounts receivable, denial rates, and collection percentages; develop and implement improvement plans.

•Ensure compliance with FQHC-specific billing requirements, Medicaid/Medicare regulations, and payer contracts.

•Collaborate with clinical teams to ensure accurate documentation and coding for services rendered.

•Resolve complex billing issues and payer disputes in a timely manner.

•Prepare and present revenue cycle performance reports to the ICFO and leadership team.

•Stay informed on healthcare reimbursement trends, payer policy changes, and regulatory updates.

•Recommend and implement process improvements to enhance efficiency, accuracy, and patient satisfaction.

•Other duties as Assigned: Perform other related duties and responsibilities as required to support the operational needs of the health center, which may include assisting with special projects, participating in committee meetings, or providing cross-coverage for other administrative functions.

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Qualifications

•Bachelor’s degree in Healthcare Administration, Business, Finance, or related field (or equivalent experience).

•Minimum of 5 years of progressive experience in healthcare revenue cycle management; FQHC experience strongly preferred.

•In-depth knowledge of CPT, HCPCS, and ICD-10 coding, as well as payer reimbursement methodologies.

•Strong leadership skills with proven ability to manage and develop teams.

•Excellent problem-solving, analytical, and organizational skills.

•Effective communication skills, both written and verbal, with the ability to work collaboratively across departments.

•American Association of Professional Coders certificaiton

Technical Proficiency

•Proficiency with electronic health record (EHR) and practice management systems (e.g., eClinicalWorks, NextGen, or similar).

•Advanced skills in Microsoft Excel, Word, and reporting tools.

•Familiarity with clearinghouse systems and payer portals.

•Ability to analyze and interpret financial and operational data to drive decision-making.

Physical Requirements

•Prolonged periods of sitting at a desk and working on a computer.

•Ability to lift up to 15 pounds occasionally.

•Visual acuity to review detailed billing and coding documentation.

•May require occasional travel between clinic sites.

General Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. Management reserves the right to revise or change job duties and responsibilities as the need arises.