JOB DESCRIPTION- EXEMPT
PURPOSE: This position is responsible for leading and supporting the billing team in collaboration with billing managers,
the CFO, and COO. This role ensures the integrity and efficiency of the organization’s revenue cycle by overseeing
monthly revenue processes, maintaining regulatory compliance, optimizing reimbursement, and promoting excellence in
customer service.
DESCRIPTION
Under the supervision of the Chief Financial Officer, the Revenue Cycle Manager is responsible for overseeing and
optimizing all aspects of the revenue cycle within a Federally Qualified Health Center (FQHC), including billing, coding,
collections, and reimbursement processes. This role ensures the financial health of the organization by maintaining
compliance with federal, state, and payer regulations, improving workflow efficiency, and maximizing revenue while
supporting access to care for all patients.
JOB RESPONSIBILITIES (include, but are not limited to)
• Oversee and optimize the entire revenue cycle process, from appointment scheduling through patient account
payment.
• Supervise all billing and coding staff, ensuring team members are well-trained, supported, and equipped to
perform at a high level.
• Conduct regular audits and reviews of billing and coding staff work to ensure accuracy, timeliness, and
compliance.
• Ensure providers complete and sign visit documentation in accordance with policies and timelines.
• Facilitate quarterly external coding audits and take corrective actions when needed to maintain billing accuracy
and compliance.
• Respond to escalated patient billing questions and ensure the team provides excellent customer service in a
timely manner.
• Monitor key performance indicators (e.g., percent collected of billed charges, denial rates, days in A/R) and lead
continuous quality improvement initiatives as needed.
• Review and update the fee schedule annually to ensure it remains competitive and compliant.
• Review and update the Sliding Fee Scale annually based on Federal Poverty Guidelines.
• Administer and analyze the annual Sliding Fee Scale Patient Surveys; work with the CFO to identify and
implement changes based on survey feedback.
• Provide ongoing training and education to staff across departments to promote revenue cycle awareness and
positive impact on billing outcomes.
• Support the CFO with monthly financial reports, the annual financial audit, and cost report preparation as
needed.
• Collaborate with leadership to improve cross-departmental communication and understanding of revenue cycle
functions.
• Maintain strict confidentiality of patient and organizational information in accordance with HIPAA and all
applicable regulations.
• Demonstrate excellent customer service, multitasking, and communication skills in a fast-paced, mission-driven
environment.
• Serve as a collaborative and proactive leader who fosters a culture of integrity, accountability, and continuous
improvement.
• Other duties as assigned.
QUALIFICATIONS:
• Associate’s degree in business administration, Health Care Administration, Finance or Accounting or related field
required. Bachelor’s or master’s degree, strongly preferred.
• At least 5 years of experience in medical billing/revenue cycle management, with 2+ years in a supervisory or
leadership role.
• Experience in a Federally Qualified Health Center (FQHC) or community health setting strongly preferred.
• Professional Coder Certification, preferred.
• Knowledge of Medicaid, Medicare, commercial insurance billing, and federal grant funding expectations.
• Familiarity with UDS reporting and Medicaid wraparound processes.
OTHER QUALIFICATIONS:
• Ability to interpret, analyze, evaluate data, and to conduct research.
• Ability to prioritize, focus, set, and accomplish goals.
• Ability to analyze problems and formulate plans, solutions and course of action.
• Strong managerial and leadership skills.
• Ability and judgment to handle confidential and sensitive information with discretion and tact.
• Proficiency in understanding and applying methods, techniques and skills required to perform job.
• Knowledge of medical coding, billing, follow up, and collection process.
• Knowledge of third party payers, State and Federal Programs.
• Knowledge of Athena and medical records information system.
• Proficient with EHR and billing software systems.
• Knowledge of medical terminology.
• Ability to develop and implement strategies for efficient workflow.
• Ability to develop, analyze, implement, and monitor productivity levels and quality improvement strategies.
• Excellent communications skills, verbal and written.
• Punctuality, dependability, and reliability.
• Proficient in analyzing revenue cycle metrics and driving process improvements.
• Strong understanding of CPT/ICD-10 coding, payer guidelines, and documentation requirements.
