Job Description

Job Description

Job Description

Description:

SUMMARY

The Revenue Cycle Manager leads and oversees the full revenue cycle, including billing, accounts receivable, appeals, collections, and payer dispute resolution. This role is responsible for driving timely reimbursement, improving AR performance, ensuring regulatory compliance, and strengthening revenue recovery efforts. Serving as the primary point of contact for insurers, patients, and third parties, this position partners closely with the Director of Finance on revenue reporting and financial accuracy. The ideal candidate is assertive, analytical, and mission-driven, with the ability to navigate complex payer challenges, manage escalations, and advocate for appropriate reimbursement while maintaining professionalism and compassionate patient support.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

• All Leaders will practice Just Culture principles.

• Revenue Cycle & Dispute Resolution

• Oversee billing, claims submission, accounts receivable, collections, and appeals

• Monitor AR performance, drive strategic collection efforts, and resolve payer issues

• Serve as primary point of contact for insurance companies, TPAs, and legal partners regarding claim disputes and escalation

• Lead the Independent Dispute Resolution (IDR) process end-to-end — including submissions, evidence preparation, communication, timelines, and outcome follow-through

• Prior IDR experience is strongly preferred

• If not yet experienced, demonstrates readiness to efficiently learn and independently manage the IDR process, as it is a critical component of this role

• Compliance & Regulatory Standards

• Ensure billing, documentation, and data handling adhere to HIPAA requirements, No Surprises Act (NSA), IDR regulations, and other applicable healthcare compliance standards

• Maintain strict confidentiality and compliant handling of PHI in all systems and communications

• Keep current on payer rule changes, reimbursement policies, federal/state requirements, and regulatory updates impacting claims and dispute resolution

• Accounting & Financial Support

• Collaborate with the Director of Finance on revenue recognition, contractual allowance estimates, and month-end close support

• May assist in the preparation of journal entries related to revenue and adjustments

• Ensure audit-ready records, support data integrity, and maintain strong revenue documentation practices

• Assist the Executive Director and Director of Finance developing the annual budget

• Team Leadership & Process Improvement

• Supervise billing personnel, provide coaching and discipline as needed, and ensure continuous improvement

• Develop workflows, policies, and controls to reduce denials, shorten AR days, and increase cash yield

• Identify trends, assess payer behavior, and implement strategic improvements for revenue recovery

• Supports Just Culture and demonstrates core principles consistently

• Cross-Functional Communication

• Partner with medical crews, operations, and leadership to resolve billing questions

• Ensures clinical documentation supports accurate medical necessity

• Provides education related to documentation to clinical staff as needed

• Present AR insights, payer challenges, and collection performance in a clear and actionable manner

• Act as an internal subject matter expert on insurance reimbursement, patient financial inquiries, collections, and dispute pathways

PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to stand; walk; use hands to manipulate objects, tools, or controls; reach with hands and arms; talk and hear. The employee must occasionally lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds with the assistance of others. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. This includes a highly regulated, climate-controlled, low-to-moderate noise environment.

EQUAL EMPLOYMENT OPPORTUNITY

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Required:

• Bachelor’s degree in Accounting, Finance, Healthcare Administration, or related field plus 5 years of healthcare billing, accounts receivable, or revenue cycle experience or a combination of education and experience.

• Experience in managing billing staff or AR operations

• Knowledge of insurance processes, claim submission, and collections

• Strong communication, negotiation, and problem-solving skills

Preferred:

• Familiarity with IDR or insurance dispute resolution processes a huge plus

• Accounting experience, including revenue recognition and allowance calculations

• Experience in a non-profit or air ambulance/EMS environment

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