Revenue Cycle Manager
5 days ago
Arverne
Job Description POSITION SUMMARY: Under the direction of the Vice President of Revenue Cycle and Health Information Management, the Revenue Cycle Manager oversees all revenue cycle functions for the Joseph P. Addabbo Family Health Center, a Federally Qualified Health Center (FQHC). The Manager ensures accurate, compliant, and timely billing, coding, collections, and reimbursement across medical, pediatric, dental, behavioral health, specialty, and enabling services. This role provides direct and indirect oversight of front end, mid cycle, and back end operations and partners closely with clinical, operational, and finance leadership to optimize revenue integrity, reduce denials, and support the financial sustainability of the organization. Responsibilities include developing and implementing policies, leading and supporting staff and vendor partners, and maintaining electronic and paper based systems in accordance with organizational policies and all applicable federal and state regulations, including HRSA, CMS, Medicaid, Medicare, and UDS reporting requirements. The Revenue Cycle Manager also ensures compliance with HIPAA and internal privacy/security standards and stays current on FQHC specific billing rules, PPS rate changes, and managed care contract requirements. This is a key leadership role that requires strategic thinking, operational excellence, and strong collaboration across the health center and the community we serve. RESPONSIBILITIES: 1. Leadership & Oversight • Direct, supervise, and develop staff across registration, eligibility, coding, billing, and collections; this will entail strategic collaboration with Clinical Operations division and clinical leadership, and the direct oversight of revenue cycle vendor related services., • Establish and enforce clear performance metrics and accountability standards for the revenue cycle team and/or revenue cycle vendor services., • Provide ongoing training on FQHC billing rules, payer updates, and compliance requirements. 2. Front-End Revenue Cycle Management • Through the collaboration with Clinical Operations division, ensure accurate patient registration, insurance verification, sliding fee scale application, and collection of patient responsibility., • Collaborate with internal stakeholders to improve and maintain workflows for prior authorizations, referrals, and financial counseling., • Collaborate with clinic managers to reduce registration errors and improve point of service collections. 3. Mid-Cycle Management (Coding & Documentation) • Partner with clinical leadership to improve documentation quality and reduce coding-related denials., • Monitor coding denials and communicate trends to leadership and resource(s) leading coding initiatives with the clinical providers., • Collaborate with and contribute to routine audits of provider documentation and coding. 4. Back-End Revenue Cycle Management • Oversee claims submission, payment posting, denial management, and accounts receivable follow up; this will include management of the related revenue cycle vendor services., • Maintain timely and accurate billing for Medicaid, Medicare, commercial plans, self-pay, and grant funded services., • Monitor AR aging and implement strategies to reduce outstanding balances and write-offs. 5. Compliance & Regulatory Requirements • Ensure adherence to federal and state regulations, including HRSA, CMS, Medicaid, Medicare, and UDS reporting requirements., • Maintain compliance with HIPAA and internal privacy/security policies., • Stay current on FQHC-specific billing rules, PPS rate changes, and managed care contract requirements., • Develops, updates, recommends, and implements Revenue Cycle policies and procedures in accordance with respective regulatory requirements. 6. Reporting & Analytics • Produce regular reports on AR, denials, cash collections, payer trends, and productivity., • Analyze data to identify revenue leakage, operational bottlenecks, and opportunities for improvement., • Support annual audits, cost reports, and UDS submissions. 7. Cross-Department Collaboration • Work closely with Finance to support budgeting, forecasting, and month-end closure., • Partner with Operations and Clinical teams to align workflows and improve patient access and throughput., • Collaborate with IT/EHR teams to optimize system configuration, templates, and revenue cycle tools. 8. Other duties assigned. Equal Opportunity Employer Joseph P. Addabbo Family Health Center is an Equal Opportunity Employer. We value diversity and do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status.
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