Revenue Cycle Manager

Open until filled

JOB SUMMARY-
The Revenue Cycle Manager is responsible for the oversight, coordination, and performance of all revenue cycle functions for Sophie Trettevick Indian Health Center (STIHC). This position oversees patient access, insurance eligibility, patient financial services, alternate resources, payer relations, and revenue cycle operations to ensure accurate reimbursement, regulatory compliance, and financial sustainability. The Revenue Cycle Manager serves as the primary liaison for contracted billing and credentialing services, providing oversight of vendor performance, provider enrollment and credentialing activities, payer relations, and reimbursement operations. The position also serves as the revenue cycle lead for the implementation, optimization, and ongoing support of the Epic Electronic Health Record (EHR) system, ensuring revenue cycle workflows, billing processes, reporting, and reimbursement functions are effectively integrated and maintained. Working collaboratively with clinical, administrative, information technology staff, and external partners, this position develops and implements strategies to optimize revenue cycle performance, maximize reimbursement opportunities, and support the organization's mission of providing quality healthcare services to Tribal and community members.

ESSENTIAL JOB DUTIES
• Oversee all revenue cycle operations, including patient registration, insurance verification, eligibility determination, charge capture, coding, billing, collections, accounts receivable, denial management, and patient financial services.
• Supervise and support registration, benefits coordination, and revenue cycle staff, including training on revenue cycle processes, compliance requirements, and workflow improvements.
• Serve as the primary liaison and contract manager for contracted billing and credentialing vendors, ensuring services are performed accurately, timely, and in compliance with organizational and regulatory requirements.
• Monitor contractor performance related to claims processing, reimbursement, denial management, accounts receivable follow-up, payer enrollment, and provider credentialing activities.
• Coordinate with contracted credentialing vendors, Human Resources, providers, and payers to support provider onboarding, enrollment, credentialing, and recredentialing activities and minimize reimbursement delays.
• Negotiate, maintain, and monitor payer contracts and relationships with Medicare, Medicaid, commercial insurers, and other third-party payers.
• Oversee patient benefits coordination, alternate resources, insurance enrollment programs, and financial assistance initiatives to maximize coverage and reimbursement opportunities.
• Ensure compliance with Tribal, Indian Health Service, federal, state, payer, HIPAA, CMS, and applicable coding requirements.
• Monitor and analyze revenue cycle performance metrics, including accounts receivable aging, denial rates, collection rates, and claim acceptance rates, and recommend corrective actions and process improvements.
• Collaborate with clinical, administrative, information technology staff, and contracted vendors to optimize revenue cycle workflows, documentation practices, and system functionality.
• Develop, implement, and maintain revenue cycle policies, procedures, internal controls, and process improvement initiatives.
• Prepare revenue cycle and contractor performance reports for leadership and participate in audits, accreditation activities, and compliance reviews.
• Perform other related duties as assigned.

ESSENTIAL JOB DUTIES RELATED TO EHR MIGRATION
• Serve as the revenue cycle lead for Electronic Health Record (EHR) implementation and optimization projects, including the transition to Epic.
• Collaborate with information technology staff, clinical departments, vendors, and implementation teams to ensure revenue cycle workflows, billing processes, payer requirements, and reporting needs are accurately configured and maintained within Epic.
• Participate in system design, testing, training, validation, and go-live activities to ensure successful implementation and minimal disruption to revenue cycle operations.
• Monitor revenue cycle performance following implementation, identify system or workflow issues affecting reimbursement, and develop corrective action plans to optimize financial outcomes and operational efficiency.

EDUCATION
• Associate's degree in Healthcare Administration, Business Administration, Finance, Accounting, or combination of education, training and relevant experience. Bachelor's degree preferred.

MINIMUM RELATED EXPERIENCE
• Minimum of 4 years of experience in program management such as healthcare revenue cycle management, medical billing, patient financial services, business administration, or finance.
• Experience with Medicare, Medicaid, commercial insurance, and third-party reimbursement processes preferred.
• Two years of supervisory experience.

REQUIRED LICENSES/CERTIFICATIONS
• Valid and unrestricted Washington State Driver’s License

KNOWLEDGE AND ABILITIES
Knowledge of:
• Electronic Health Records (EHR), billing systems, and revenue cycle reporting tools.
• IHS policies and regulations on alternative resources, CFR 42-36.21(A) and 23(F).
• How to manage vendor relationships, monitor contracted billing and credentialing services, and collaborate with internal and external stakeholders.
Able to:
• Maintain confidentiality and adhere to all HIPAA, Privacy Act, organizational, and applicable federal, state, Tribal, and IHS privacy and security requirements.
• Abide by the Privacy Act of 1974 which mandates incumbent shall maintain complete confidentiality of all administrative, medical and personnel records

• Support STIHC’s mission by promoting culturally respectful, community-centered care while participating in quality improvement, compliance, and accreditation activities to ensure excellence in patient services and organizational performance.
• Organize, plan, coordinate, and carry-out assigned tasks with accuracy and attention to detail.
• Demonstrate effective leadership, communication, and interpersonal skills.
• Continually learn and utilize a variety of information systems and software.
• Pass pre-employment drug screening and background check(s).

SPECIAL REQUIREMENTS
Immunization Requirements: Must be fully immunized against measles, and rubella and provide official documented proof of vaccination prior to employment. Employees are required to provide proof of other immunizations as recommended for healthcare workers by the Centers for Disease Control and Prevention, or of immunity to these diseases.

All employees shall have tuberculin (TB) test upon employment and annually thereafter, or have a follow-up plan approved by employee health if there is a positive test

Special Consideration: if you are allergic to any component of the vaccine or have documented history of severe reaction to vaccine or are currently pregnant you may not have to be immunized, however, you are required to provide documentation/proof, to be considered for employment.

PHYSICAL REQUIREMENTS
Manual and finger dexterity for the operation of personal computers, office machines and routine paperwork. Tolerance to be exposed to computer screen for prolonged periods. Stamina to sit, stand and/or walk for prolonged periods. Mobility to bend, stoop, and/ or climb stairs. Ability to lift objects weighing up to 20 lbs. occasionally. Operate a motor vehicle.