Full‑Time | Finance Office | Hospice & Palliative Care Services | Raleigh, NC
Overview The Revenue Cycle Manager is a key member of the Finance Office and oversees all aspects of the hospice revenue cycle, including billing and reimbursement activities for affiliated palliative care and geriatric primary care services. This role ensures accurate, compliant, and timely billing, collections, and reimbursement while driving operational effectiveness across eligibility verification, coding, billing, and accounts receivable. The ideal candidate is organized, analytical, and mission‑driven, thriving in a compassionate nonprofit hospice environment. The schedule for this position is Monday-Friday 8:30am-5:00pm.
Manage the full revenue cycle, including insurance verification, coding, billing, collections, and A/R follow‑up.
Ensure compliance with Medicare, Medicaid, commercial insurance, and hospice‑specific regulatory requirements.
Monitor claims accuracy, timeliness, and reimbursement performance; reduce denials through proactive oversight.
Maintain and optimize revenue cycle workflows and internal controls.
Supervise and support revenue cycle team members, including billing specialists and support staff.
Partner with Clinical, Admissions, Quality, and Finance teams to ensure aligned processes and seamless communication.
Provide training on documentation requirements, billing best practices, and regulatory updates.
Develop and maintain dashboards and performance reports for A/R aging, cash collections, denial trends, and billing metrics.
Identify root causes of billing issues or denial patterns and lead corrective action initiatives.
Forecast cash flow impacts, monitor KPIs, and recommend process improvements.
Interface with third‑party payors to ensure timely payment and develop procedures that support efficient claims processing.
Assist the CFO with rate development and payor contract negotiations.
Support annual audit activities related to revenue cycle functions.
Communicate professionally with patients, families, referral sources, and payors.
Participate in special projects and perform other duties as assigned.
Demonstrate professionalism, empathy, and alignment with mission‑driven hospice values.
Adhere to organizational policies, ACHC Standards, and Medicare Conditions of Participation.
Ensure compliance with all applicable state and federal regulations.
Promptly communicate concerns or risks to leadership.
Bachelor’s degree in Business, Healthcare Administration, Finance, Accounting, or related field.
3–5+ years of revenue cycle management experience, preferably in hospice, home health, or post‑acute care.
Strong organizational skills with the ability to manage multiple priorities and meet deadlines.
Excellent analytical and problem‑solving skills; experience with data analysis and reporting.
Knowledge of Medicare/Medicaid hospice billing regulations.
Experience with EMR systems preferred; Axxess (hospice) and Epic (palliative care) experience a plus.
Proficiency in Microsoft Excel and Word.
Ability to meet physical and sensory requirements of the role, including prolonged computer use and occasional lifting up to 30 lbs.
Ability to master agency software programs and electronic billing practices.
Understanding of billing requirements, contracts, and regulatory guidelines.
Experience in a nonprofit or mission‑driven healthcare environment.
Relevant certifications (CHAM, CRCR, HFMA).
Experience supervising or leading a small operational team.
Analytical Thinking — Interprets data, identifies trends, and drives data‑based decisions.
Problem Solving — Navigates complex billing and reimbursement challenges proactively.
Organization & Prioritization — Manages competing deadlines with accuracy and attention to detail.
Communication — Clearly conveys financial and operational information to diverse stakeholders.
Integrity & Confidentiality — Protects sensitive patient and financial information.
Mission Alignment — Demonstrates commitment to compassionate, nonprofit hospice care.