Revenue Cycle Manager

Revenue Cycle Manager 

• Department: Billing/Finance 
• Reports To: CFO/CEO

Position Summary

The Revenue Cycle Manager is responsible for the overall management and performance of the revenue cycle within a high-volume orthopedic practice. This role oversees all functions related to patient accounts, charge capture, coding, billing, accounts receivable, and collections to ensure timely, accurate reimbursement and compliance with regulatory requirements. The manager will lead staff, optimize workflows, and drive continuous improvement in financial outcomes.

Key Responsibilities

• Oversee end-to-end revenue cycle operations including insurance verification, authorizations, coding, charge entry, billing including all applicable follow-up and appeals, and collections

• Monitor key performance indicators (KPIs) such as days in accounts receivable (A/R), denial rates, net collection rates, and charge lag

• Ensure accurate and compliant coding practices in accordance with CPT, ICD-10, and payer-specific guidelines

• Manage claim submission processes and follow-up on unpaid or denied claims

• Identify trends in denials and implement corrective action plans to reduce rejections and improve reimbursement

• Supervise, train, and evaluate revenue cycle staff, including billing, coding, and A/R personnel

• Collaborate with physicians and clinical staff to improve documentation and charge capture accuracy

• Maintain relationships with payers and resolve escalated reimbursement issues

• Oversee credentialing and payer enrollment processes, as applicable

• Develop, implement, and maintain revenue cycle policies and procedures

• Prepare regular financial and operational reports for leadership

• Ensure compliance with federal and state regulations, including HIPAA

Qualifications

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

• Minimum of 5 years of experience in revenue cycle management, preferably in orthopedic or surgical specialty practice

• Strong knowledge of medical billing, coding, and reimbursement methodologies

• Familiarity with orthopedic procedures and surgical billing preferred

• Experience with electronic health record (EHR) and practice management systems, prefer Athena One experience.

• Professional certification (CPC, or equivalent) preferred

Skills & Competencies

• Strong leadership and team management skills

• Excellent analytical and problem-solving abilities

• Detail-oriented with a focus on accuracy and compliance

• Effective communication and interpersonal skills

• Ability to manage multiple priorities and meet deadlines

• Proficiency in financial reporting and data analysis

Work Environment

• Office-based role within a fast-paced orthopedic practice

• May require occasional extended hours based on operational needs