Manager, Revenue Cycle Management

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Requirements:

• Member-focused mindset, passionate about improving the revenue cycle process to enhance patient experiences and outcomes.
• At least 5 years of experience in Revenue Cycle Management, particularly in healthcare settings, virtual care delivery or telemedicine.
• Understanding of billing processes, coding, revenue cycle compliance, and experience with various payers.
• Experience in end-to-end design and implementation of revenue cycle processes and platforms.
• Strong analytical skills, comfortable analyzing data and utilizing KPIs to inform decision-making.
• Empathy, driven to solve problems for others and collaborate effectively with cross-functional teams.
• Commitment to inclusivity and enhancing team diversity.
• Comfort with ambiguity and ability to thrive in fast-paced environments.

Responsibilities:

• Overseeing the end-to-end revenue cycle process, from member registration to claims submission & processing to cost share collection, while ensuring compliance to regulatory, legal, and contractual standards.
• Collaborating with vendor representatives, consultants, and partners’ claims teams to implement new revenue cycle flows and/or systems to support expansion.
• Completing a gap assessment and collaborating with clinical, financial, and operational teams to identify areas for improvement in existing processes.
• Analyzing key performance indicators (KPIs) to drive operational excellence and provide insights to stakeholders.
• Ensuring strong, proactive vendor management and seeking to identify solutions to improve revenue cycle functions.
• Serving as a liaison between external partners and internal departments to proactively mitigate and resolve issues and improve relationships.
• Developing policies and process flow documentation to ensure standardization and adherence to best practices and compliance standards.
• Monitoring industry trends and regulatory changes to ensure compliance and adjust practices as necessary.