Revenue Cycle Manager

Job Title: Revenue Cycle Manager

Department: Billing

Reports to: Controller

FLSA Status: Exempt

Prepared by: Human Resources

Last Modified: 09/21/2021, 03/04/2026

Summary

The Revenue Cycle Manager (RCM Manager) will oversees all functions in the Billing/Accounts Receivable department and is responsible and accountable for the revenue cycle process, working collaboratively with front line staff, clinicians, department managers, and senior leadership to maximize revenue, provide reports demonstrating trends in patient accounts, and ensure accuracy and compliance in billing, collections, denials and ensure related financial screening areas (eg. Sliding fee discount policy, patient refunds, patient collections, COVID related claims, write offs).

General Accountabilities

• Oversee day-to-day revenue cycle operations, managing the full in-house billing lifecycle from charge capture through collections and reconciliation.
• Manage billing department staff (5) in daily activities, assign work, set completion dates, review work and manage performance in accordance with established policies and procedures.
• Supervise, hire, train, mentor, and evaluate billing and revenue cycle staff; manage workflow, productivity standards, and performance accountability.
• Establish and monitor productivity goals, AR benchmarks (including aging), and key financial metrics; remove barriers to optimize performance.
• Stay current with company’s policies and procedures regarding AR activity such as, reviewing month end reports to guarantee the AR is below 20% over 90 days, identifying trends.
• Analyze denials, reimbursement trends, unbilled claims, credit balances, and AR variances; implement corrective action and oversee appeals and rebilling.
• Prompt response to requests for information, both internally and externally initiates and maintains direct contact with CHMB clients, engaged in proactive resolution of issues and timely response to questions and concerns.
• Ensure accurate charge entry, claim submission, payment posting, adjustments, and reconciliation within EHR and Practice Management systems.
• Monitor third-party billing, outsourced AR vendors, and payer/IPA portals to ensure accuracy, compliance, and optimal reimbursement.
• Maintain compliance with billing regulations, payer requirements, internal policies, and audit standards; support cost reports, UDS reporting, Medicare/Medi-Cal reconciliations, and audits.
• Delivers timely required reports to the Controller; initiates and communicates the resolution of issues, such as payer denial trends, collections accounts, inaccurate or incorrect charges, vendor input and implementation.
• Develop, implement, and improve revenue cycle workflows, SOPs, benchmarks (including FQHC standards), fee schedules, and billing policies.
• Prepare and present financial, operational, and AR performance reports to leadership, physicians, and stakeholders; assist with budgeting and forecasting.
• Serve as liaison to clients, patients, payers, and internal departments; resolve financial inquiries and AR issues with professionalism and timely follow-up.
• Partner with executive and operational leadership to ensure new programs and services are financially viable and billable.
• Conduct financial analysis, variance review, journal entry oversight, and month-end reporting related to revenue and receivables.
• Collaborate across departments to improve registration accuracy, billing workflows, and revenue cycle integrity.
• Document procedures, maintain transparency in reporting, and provide accurate, timely information to stakeholders.
• Perform additional duties and special projects as assigned to support organizational goals.