Revenue Cycle Manager
Description
At the Center for Human Development (CHD), Care Finds a Way. CHD is growing its outpatient and primary care services, creating exciting new opportunities within our Revenue Cycle Management Department! We are a diverse, inclusive, and dynamic team dedicated to promoting, enhancing, and protecting the dignity and welfare of people in need.
We are seeking an experienced, analytical Revenue Cycle Manager to oversee and optimize CHD's end-to-end revenue cycle. Reporting directly to the Sr. Director of Revenue Cycle Management, you will lead billing, coding, AR, denial management, and authorization staff to ensure accurate billing, timely reimbursement, and full revenue capture across our behavioral health, primary care, CBHC, CBHI, SUD, residential, and community-based service lines.
The Opportunity: Lead, Optimize, and Drive Impact:
As the Revenue Cycle Manager, you will partner closely with Clinical Operations, Finance, IT, Compliance, and Program Leadership to strengthen cash flow, reduce preventable denials and write-offs, and support CHD’s long-term financial sustainability.
Key Responsibilities:
- Revenue Cycle Operations: Oversee end-to-end workflows—including eligibility verification, authorization, charge capture, coding, claim submission, payment posting, and collections; establish team performance and turnaround standards.
- Claims & AR Management: Ensure accurate, timely claim submission to MassHealth, Medicare, Medicaid managed care plans, and commercial payers; set and track targets for clean claim rates, days in AR, and net collection rates.
- Denial Prevention & Appeals: Maintain a formal denial prevention process; analyze root causes across programs and providers, oversee appeals and reconsiderations, and coordinate corrective actions with operational and IT teams.
- Credentialing & Compliance Integrity: Collaborate with credentialing staff to prevent revenue loss from enrollment delays; ensure all billing practices align with CMS, MassHealth, commercial payer rules, and HIPAA regulations.
- Data Analytics & Reporting: Build and maintain executive revenue cycle dashboards; translate complex data into actionable recommendations to optimize reimbursement across all service lines.
- Team Leadership: Supervise, train, and evaluate assigned billing, coding, AR, and authorization staff; promote a culture of accountability, continuous improvement, and cross-departmental collaboration.
Requirements & Qualifications:
- Education: Bachelor’s degree in Healthcare Administration, Business Administration, Accounting, Finance, or a related field required (Master’s degree preferred).
- Experience: Minimum of 5 years of progressive healthcare revenue cycle experience, with at least 3 years in a managerial/supervisory capacity.
- Industry Knowledge: Deep familiarity with MassHealth, Medicare, commercial insurance, managed care, authorizations, and denial workflows. Experience in behavioral health, community health, or non-profit healthcare strongly preferred.
- Technical & Analytical Skills: Proficiency in EHR/practice management systems, clearinghouses, and claim-editing tools; advanced Excel skills and experience with reporting tools like Power BI.
- Certifications (Preferred): CRCR, CPB, CPC, CHAA, or comparable HFMA revenue cycle credentials.
Success Factors:
- Strategic & Analytical Mindset: Translates high-volume revenue data into concrete operational improvements and leakage prevention.
- Collaborative Partner: Bridges communication seamlessly between clinical operations, credentialing, IT, and finance teams.
- Accountable Leader: Sets clear performance metrics, coaches staff effectively and drives high-performing revenue cycle operations.
Care Finds a Way:
At CHD, celebrating differences is a daily practice. We offer a competitive salary range of $90,000 – $100,000, along with a comprehensive benefits package including health, dental, and life insurance, 403(b) retirement planning, generous paid time off, and paid holidays.
Connect with our team today! If you are an experienced revenue cycle leader ready to support CHD’s expanding outpatient and primary care services, apply today to join our team!
