Revenue Cycle Manager
On-siteBucksport, Maine, United States
Job Summary
Direct and manage all components of the revenue cycle, from claims processing and clearinghouse operations to A/R management, payer relations, and staff development. Develop, implement, and maintain billing standard operating procedures while monitoring revenue performance to provide monthly reports and recommendations. Oversee claims submission and resolution of rejected claims, ensuring compliance with Medicare, Medicaid, and commercial payer rules. Manage A/R aging, identify underpayments, and conduct internal audits of coding and billing accuracy to coach staff on best practices. Hire, train, supervise, and evaluate billing staff, fostering accountability and continuous improvement. Work with clinical and administrative teams to streamline processes and maintain strong relationships with payers, vendors, and credentialing partners.
Required Qualifications
- Minimum 5 years of medical billing or business office management
- At least 2–3 years in a supervisory or department leadership role
- Bachelor's degree in business, Healthcare Administration, Finance, or related field
- Equivalent progressive experience in revenue-cycle leadership
- Proficiency in EMR billing systems
- Proficiency in clearinghouse platforms
- Proficiency in Microsoft Office applications
- Strong analytical and problem-solving skills
- Ability to interpret financial data and identify trends
- Excellent communication, presentation, and organizational abilities
- Demonstrated leadership, professionalism, integrity, and adaptability
- Ability to establish priorities, coordinate work activities, and manage competing deadlines
- Direct and manage all components of the revenue cycle
- Develop, implement, and maintain billing and revenue cycle standard operating procedures (SOPs)
- Monitor revenue performance, analyze trends, and provide monthly reports, metrics, and recommendations to leadership
- Oversee claims submission, clearinghouse workflows, and resolution of rejected/denied claims
- Ensure compliance with Medicare, Medicaid, and commercial payer billing requirements
- Strong focus on FQHC regulations
- Act as EMR billing super-user and co-administrator
- Partner with the CAS for issue resolution and system optimization
- Manage A/R aging
- Identify underpayments
- Determine root causes
- Implement corrective actions
- Conduct regular internal audits of coding and billing accuracy
- Provide coaching and education to staff
- Monitor open encounters
- Ensure timely completion
- Hire, train, supervise, and evaluate billing staff
- Foster an environment of accountability, teamwork, and continuous improvement
- Provide ongoing staff education regarding billing best practices, regulatory updates, and workflow expectations
- Work with clinical and administrative teams to streamline processes and improve revenue cycle outcomes
- Maintain strong relationships with payers, vendors, coding consultants, credentialing partners, and outside billing resources
- Oversee provider insurance credentialing processes
- Supervise relationships and performance of outside payment posting vendors and contracted collection agencies
- Be committed to the mission and values of the Bucksport Regional Health Center
- Work as a member of the Finance team
- Be punctual for scheduled work
- Use time appropriately
- Work in harmonious relationships with all staff, patients, vendors and others
- Perform duties in a conscientious, cooperative manner
- Perform the required amount of work in a timely fashion with a minimum of errors
- Be neat and maintain a professional appearance
- Maintain confidentiality in accordance with HIPAA and organizational policies
- Represent BRHC professionally in interactions with patients, staff, and community partners
- Frequently stand
- Frequently walk
- Frequently sit
- Use hands to handle, or feel, including operation of a standard computer keyboard
- Reach with hands and arms
- Talk, see and hear
- Prolonged sitting required
- Eye hand coordination and manual dexterity
- Occasionally lift/move up to 25 pounds
- Bend, stoop, stretch or crouch
- Close vision
- Distance vision
- Ability to adjust focus
Desired Qualifications
- Experience with FQHC billing
- Experience with Medicare/Medicaid
- Experience with commercial payer rules
- Experience with compliance requirements
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