Senior Manager, Revenue Cycle Management, Provider Operations
Core
Leading and optimizing revenue cycle operations, professional billing, and coding strategies for a multi-state medical group to ensure accurate coding, compliant billing, and timely reimbursement.
Role type
Senior Manager, Healthcare Revenue Cycle & Provider Operations
Builds
Scalable revenue cycle strategies, workflows, and governance for a growing medical group
Domain
Healthcare / Health Insurance / Revenue Cycle Management
Required skills
Healthcare revenue cycle management, professional billing and coding (CPT, ICD-10-CM, HCPCS), claims management, denial management, data analysis, root-cause analysis, cross-functional leadership, strategic planning
Preferred skills
CPC/CCS/CPMA certification, experience leading coding teams, multi-state medical group experience, risk-adjustment coding (HCC), credentialing processes, vendor management
Technologies
CPT, ICD-10-CM, HCPCS, CCI/NCCI edits
Responsibilities
Own strategy and performance of revenue cycle function including billing, coding, claims, and denials; Establish and monitor KPIs to improve clean claims and reimbursement; Lead coding and documentation integrity strategies; Partner with clinical leadership on ICD-10/HCC documentation; Evaluate payer-specific performance and requirements; Develop scalable policies and vendor oversight; Advise leadership on financial opportunities and operational risks
Seniority
Senior, hands-on IC with strategic leadership