Backend Revenue Cycle Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Facilitate and document around 45 executive sessions of the Joint Operating Committee (JOC) each month with key commercial and government payers.

• Manage partnership agreements and disseminate policy updates obtained during JOC meetings to the relevant parties.

• Serve as the primary escalation lead and senior negotiator for complex, high-value claim disputes and denials across five multi-state regions.

• Implement advanced revenue integrity strategies to expedite variance resolution and optimize reimbursement.

• Oversee continuous auditing, triage, and the monthly transmission of six specialized escalation logs.

• Supervise vendor communication channels, including R1 RCM, to ensure systematic inventory clearance and compliance with Ascension revenue standards for high-value accounts.

• Lead and develop Senior Analysts by establishing review benchmarks for claim denial inquiries.

• Establish criteria for escalation documentation and manage daily task distribution across competing regional priorities.

• Conduct structured monthly assessments on aged inventory to determine whether items should be forwarded to Legal or R1 RCM for subsequent actions.

• Stay informed about updates to payer policies and contract stipulations.

⛳️ Requirements

• Certified Coding Specialist (CCS) credential from the American Health Information Management Association (AHIMA) is preferred.

• Relevant state licensure is required for the location of work.

• High School diploma or equivalent with 3 years of cumulative experience, OR an Associate's degree/Bachelor's degree with 2 years of cumulative experience, OR 7 years of relevant cumulative job-specific experience is required.

• A preference for candidates with 3 years of leadership or management experience.

• Advanced professional revenue cycle certification (e.g., CRCR, CSPR, or CSPPM) is preferred.

• Direct experience in structuring and facilitating JOC or strategic payer-provider alignment frameworks is essential.

• Extensive subject-matter expertise in major national and regional payer environments (e.g., UHC, BCBS, Cigna, Aetna, Humana) and vendor ecosystem integrations (e.g., R1 RCM) is required.

🏝️ Benefits

• Eligible for an annual bonus incentive.

• Paid time off (PTO).

• Various health insurance options and wellness plans.

• Retirement benefits including employer matching plans.

• Long-term and short-term disability coverage.

• Employee assistance programs (EAP).

• Parental leave and adoption assistance.

• Tuition reimbursement.

• Opportunities to contribute to the community.