Job Title
Revenue Cycle Manager
Reports to
Chief Financial Officer (CFO)
Status
Exempt (Salaried $72,000 - $96,000)
Job Purpose
The Revenue Cycle Manager is responsible for providing strategic and operational leadership for the organization''s entire revenue cycle, from patient scheduling and registration through final claim resolution and payment collection. This position oversees all revenue cycle functions and serves as the organization''s subject matter expert on revenue cycle operations, reimbursement, payer requirements, patient financial processes, and revenue optimization.
The Revenue Cycle Manager collaborates closely with Executive Leadership, Operations, Clinical Services, Behavioral Health, Dental, Pharmacy, Front Office, Quality, Compliance, Information Technology, and Finance to develop, implement, and continuously improve workflows that support financial sustainability, regulatory compliance, operational efficiency, and an exceptional patient experience.
This position is responsible for supervising Revenue Cycle staff, developing departmental policies and procedures, creating training resources, identifying opportunities for process improvement, resolving complex revenue cycle issues, and ensuring organizational alignment regarding revenue cycle workflows and responsibilities.
Duties & Responsibilities
Revenue Cycle Leadership and Operations
Provide leadership and oversight for all revenue cycle functions, including patient registration, insurance verification, eligibility determination, prior authorization support, charge capture, coding, billing, payment posting, denial management, accounts receivable management, and collections.
Monitor and evaluate revenue cycle performance through key performance indicators (KPIs), productivity metrics, reimbursement trends, and financial outcomes.
Develop and implement strategies to improve cash flow, reduce denials, reduce days in accounts receivable, improve clean claim rates, and maximize reimbursement.
Ensure accurate and timely claim submission, payment posting, follow-up, and resolution of outstanding accounts.
Identify revenue cycle risks and develop corrective action plans to address operational, financial, and compliance concerns.
Cross-Functional Collaboration and Workflow Development
Collaborate with organizational leaders to develop, implement, and maintain efficient revenue cycle workflows across all service lines and departments.
Partner with Front Office, Clinical Operations, Behavioral Health, Dental, Pharmacy, Quality, Compliance, Information Technology, and Finance to identify workflow gaps and implement solutions.
Serve as a resource for revenue cycle-related operational questions and assist departments in resolving complex billing, reimbursement, eligibility, and payer issues.
Participate in organizational initiatives that impact revenue cycle performance, patient access, reimbursement, or regulatory compliance.
Facilitate cross-functional discussions to clarify workflow ownership, accountability, and process expectations.
Training and Revenue Cycle Education
Develop and maintain revenue cycle training materials, reference guides, workflow documentation, and educational resources.
Ensure front office, clinical, and operational staff receive appropriate training related to registration, insurance verification, documentation requirements, patient financial communication, payer requirements, and billing workflows.
Provide ongoing education regarding Medicare, Medicaid, FQHC billing requirements, payer updates, and revenue cycle best practices.
Promote organizational understanding of revenue cycle processes and the impact of workflow decisions on reimbursement and patient experience.
Regulatory Compliance and Revenue Integrity
Ensure compliance with federal, state, and local regulations, including HIPAA, Medicare, Medicaid, HRSA, FQHC requirements, and payer-specific guidelines.
Monitor regulatory changes and communicate relevant updates to leadership and impacted departments.
Assist with internal and external audits and implement corrective action plans as necessary.
Ensure revenue cycle policies, procedures, and workflows align with applicable regulatory and contractual requirements.
Leadership and Staff Development
Directly supervise employees within the Revenue Cycle Department.
Establish performance expectations, monitor performance, and provide coaching, mentoring, and professional development opportunities.
Conduct performance evaluations and support employee growth and accountability.
Foster a culture of collaboration, accountability, continuous improvement, customer service, and problem-solving.
Financial Reporting and Strategic Planning
Prepare and present revenue cycle reports, trends, analyses, and recommendations to the Chief Financial Officer and Executive Leadership Team.
Participate in strategic planning initiatives related to financial performance, reimbursement optimization, workforce planning, and operational efficiency.
Assist with budget development, forecasting, and long-range financial planning related to revenue cycle operations.
Patient Financial Experience
Support the development of clear and consistent patient financial communication processes.
Collaborate with operational leaders to improve patient understanding of insurance benefits, financial responsibility, estimates, billing statements, and payment options.
Assist with the resolution of complex patient billing concerns and escalated reimbursement issues.
Qualifications
Required Qualifications
Bachelor''s degree in Healthcare Administration, Business Administration, Finance, Accounting, Health Information Management, or a related field; equivalent combination of education and relevant experience may be considered.
Minimum of five (5) years of progressively responsible experience in revenue cycle management, healthcare operations, medical billing, reimbursement, or related healthcare financial functions.
Minimum of three (3) years of supervisory, management, or leadership experience.
Demonstrated knowledge of healthcare revenue cycle operations, including patient registration, insurance verification, eligibility determination, charge capture, coding, claims submission, payment posting, denial management, accounts receivable, and collections.
Strong knowledge of Medicare, Medicaid, commercial insurance, payer requirements, reimbursement methodologies, and revenue cycle best practices.
Experience analyzing revenue cycle performance metrics, identifying operational opportunities, and implementing process improvements.
Demonstrated ability to develop policies, procedures, workflows, training materials, and educational resources.
Strong analytical, critical thinking, problem-solving, and decision-making skills.
Excellent written, verbal, interpersonal, and presentation skills.
Demonstrated ability to collaborate effectively with leaders, providers, clinical staff, operational departments, and external stakeholders.
Proficiency with electronic health records (EHRs), practice management systems, payer portals, Microsoft Office applications, and revenue cycle reporting tools.
Ability to maintain confidentiality and exercise sound judgment when handling sensitive information.
Preferred Qualifications
Master''s degree in Healthcare Administration (MHA), Business Administration (MBA), Public Health (MPH), Finance, or a related field.
Experience working in a Federally Qualified Health Center (FQHC), Community Health Center, Rural Health Clinic, or similar healthcare environment.
Knowledge of FQHC reimbursement methodologies, PPS/APM billing, Medicare Annual Wellness Visits, value-based care programs, and Medicaid managed care plans.
Professional certification such as CRCR (Certified Revenue Cycle Representative), CHFP (Certified Healthcare Financial Professional), CPC, CPB, or other relevant healthcare revenue cycle certification.
Experience leading cross-functional projects, workflow redesign initiatives, and organizational change management efforts.
Physical Requirements & Working Conditions
Work is primarily performed in a professional office and healthcare environment with frequent interaction with employees, patients, providers, leadership, payers, and external partners.
Regular use of computers, telephones, printers, scanners, and other standard office equipment is required.
Frequently communicates with employees, patients, and other stakeholders and must be able to exchange accurate information in these interactions.
Regularly reviews, prepares, and analyzes reports, documentation, and electronic records.
May move throughout Heartland facilities to attend meetings, collaborate with staff, or support operational needs.
Frequently remains in a stationary position while performing computer-based and administrative work.
Work requires attention to detail, problem-solving, decision-making, and the ability to manage multiple priorities in a fast-paced environment.
Must be able to perform the essential functions of the position with or without reasonable accommodation.
Details
Status: Full-Time, Exempt (Salaried)
Work Schedule: Generally Monday through Friday, 8:00 a.m. to 5:00 p.m.; additional hours may be required based on operational needs, project deadlines, meetings, audits, or organizational priorities.
Location: This position is based on-site at Bluestem Wellness, 534 Michigan Street, Lawrence, Kansas 66044.
Remote Work Eligibility: Eligible for remote work up to 25% of the fiscal year, subject to organizational policy, business needs, satisfactory performance, and supervisor approval.
Travel: Occasional local travel between Heartland locations may be required to support operational, training, leadership, or organizational needs.