Revenue Cycle Manager

billing, coding, A/R, and collections

Key Responsibilities:

1. Revenue Cycle Oversight

• Develop and implement

  strategic plans

  to optimize the revenue cycle for multiple SNF locations.
• Oversee

  Medicare, Medicaid, Managed Care, and Private Pay billing

  workflows.
• Ensure

  PDPM accuracy

  in reimbursement calculations and billing.
• Monitor

  revenue cycle KPIs

  (Days in A/R, Denial Rates, Clean Claim Rates, Collections).

2. Billing & Claims Management

• Ensure timely

  UB-04 claim submissions

  for SNF services.
• Work with

  billing teams to reduce denials and improve first-pass claim acceptance rates

  .
• Implement best practices for

  Medicaid pending claims and eligibility management

  .
• Oversee coordination between

  MDS assessments and PDPM billing compliance

  .

3. Accounts Receivable & Collections

• Develop

  A/R management strategies

  to reduce aging over 90+ days.
• Ensure timely

  collections from insurance payers and private-pay residents

  .
• Oversee

  denial management and appeals

  to maximize reimbursements.
• Implement

  patient responsibility collection procedures

  , including Medicaid spend-down processing.

4. Compliance & Regulatory Adherence

• Ensure compliance with

  CMS regulations, HIPAA, and state Medicaid guidelines

  .
• Monitor

  Medicare PDPM updates, Medicaid changes, and managed care contract requirements

  .
• Lead

  internal audits to prevent fraud, overpayments, and compliance risks

  .
• Serve as the primary liaison with

  state Medicaid agencies and CMS auditors

  .

5. Leadership & Team Management

• Manage and mentor a team of

  billing specialists, coders, A/R analysts, and compliance staff

  .
• Collaborate with

  MDS coordinators, facility administrators, and finance teams

  .
• Implement

  continuous training programs

  for billing and compliance teams.

6. Financial Reporting & Analysis

• Generate

  monthly revenue cycle performance reports

  for senior leadership.
• Analyze

  payer trends and denial patterns

  to improve cash flow.
• Provide

  budget forecasts and financial projections

  related to reimbursements.

Requirements:

• Experience:

  7+ years

  in revenue cycle management, with

  3+ years in SNF/LTC billing leadership

  .

• Expertise:

• Deep knowledge of

  PDPM, RUG-IV, and Medicaid case-mix reimbursement models

  .
• Strong experience in

  Medicare, Medicaid, and Managed Care contracts

  .
• Proficiency in

  SNF billing software

  (PointClickCare, MatrixCare, AHT, or similar).
• Familiarity with

  CMS audit processes, ADRs, and compliance programs

  .

• Skills:

• Strong leadership and

  team management

  abilities.
• Excellent

  analytical and financial acumen

  .
• Strong problem-solving and negotiation skills for

  payer disputes

  .
• Effective communication with

  executive teams and facility administrators

  .

Preferred Certifications:

• Certified Revenue Cycle Executive (CRCE)

  HFMA

• Certified Professional Biller (CPB)

  AAPC

• Certified Healthcare Financial Professional (CHFP)

  – HFMA

• Certified Compliance Officer (CHC)

  – HCCA