Revenue Cycle Manager

The Revenue Cycle Manager is responsible for overseeing financial tracking, billing processes, and insurance operations across all programs. This role ensures accurate revenue cycle management, compliance with Medicaid and commercial insurance requirements, and supports organizational financial health through reporting, auditing, and process improvement

·         Required: Education: Bachelor’s degree required. 

·         Experience: 3–5+ years in revenue cycle or healthcare billing. Experience with Medicaid, behavioral/therapy billing.

 

 

 

·         Billing 

o   Coordinate with the billing team on corrections and resubmissions 

o   Ensure timely and accurate claim submission 

o   Review billing data from EMR 

o   Attend all applicable insurance workshops 

o   Remain up to date with MMA and private insurance changes 

o   Ensure compliance with payer requirements 

 

·         Revenue/Remittance 

o   Create and manage program invoicing (contracts, private pay)

o   Seek out additional revenue sources through Medicaid and commercial insurance 

o   Conduct internal audit reviews with all Program Directors to ensure streamlined processes 

o   Assist Program Directors on additional revenue generation opportunities. 

o   Works with the Development team for revenue generation opportunities 

 

·         Credentialing 

o   Maintain group NPIs

o   Maintain payer credentialing (Medicaid, commercial) 

o   Maintain therapeutic Medicaid portals 

o   Manage payer portals (Availity, Payspan, etc.) 

 

·         Reporting 

o   Maintain/record all productivity for each therapy department

o   Create month and year-end projections with the program director's oversight 

o   Manage and track all contractual adjustments (BT, CT, CBH)

o   other duties as assigned