Manager, Revenue Cycle Operations
$100,000–$130,000 year
On-site · Texas, United States
Job Summary
Manager, Revenue Cycle Operations to lead end-to-end billing and coding across fee-for-service, capitation, and hybrid payment models, monitor claims workflows and denials for clean, compliant submissions across states and payers, and serve as escalation point for high-impact payer denials. Partner with analytics to develop dashboards for real-time decisions and revenue forecasting; drive capitation and value-based care readiness; collaborate with medical, product, and operations teams to align payment integrity with contract goals; lead cross-functional initiatives to improve performance, quality, and speed; oversee onboarding and training for billing/coding staff; manage offshore or vendor-supported teams; ensure audit-readiness and adherence to CMS/OIG/payer standards; provide weekly/monthly performance reports to leadership; optimize EHR/clearinghouse/tools and drive automation; maintain SOPs and governance; 8+ years RCM with 5+ years in leadership, CPC certification required; base salary $100k-$130k plus bonus and benefits.
Required Qualifications
- 8+ years of progressive revenue cycle experience
- 5+ years in leadership or strategic operations roles with direct accountability for results
- Proven success building or turning around RCM operations in a multi-state or multi-payer environment
- Strong command of payer policy interpretation, provider enrollment workflows, and payer portal management for Medicaid and commercial lines
- Hands-on experience with capitated and value-based payment models, encounter reconciliation, and HEDIS/quality measure integration
- Advanced Athenahealth expertise (or similar enterprise EHR) with ability to optimize claim scrub rules, taxonomy mapping, and automation logic
- Lean Six Sigma, PMP, or process optimization background strongly preferred
- Working knowledge of pediatric, primary care, or behavioral health coding and documentation standards preferred
- Proficiency in Excel, Tableau, and claims analytics tools; ability to translate data into operational insights
Desired Qualifications
- Certified Professional Coder (AAPC or AHIMA) required; additional certifications (CPPm, CPCO, or CHFP) preferred
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