Backend Revenue Cycle Manager

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

📋 Description

• Organize and document around 45 monthly executive sessions of the Joint Operating Committee (JOC) with essential commercial and governmental payers.

• Manage partnership agreements effectively.

• Distribute policy updates obtained during JOC meetings to relevant stakeholders.

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

• Implement advanced revenue integrity strategies to achieve swift variance resolution and optimal reimbursement.

• Supervise ongoing auditing, triage, and monthly updates of six specialized escalation logs.

• Manage vendor communication streams, including R1 RCM, to ensure systematic inventory clearance and compliance with Ascension revenue standards for high-dollar accounts.

• Lead and mentor Senior Analysts.

• Set review standards for inquiries regarding claim denials and escalation documentation criteria.

• Oversee daily task assignments across competing regional priorities.

• Conduct structured monthly assessments on aged inventory discussed during JOC meetings.

• Decide if items should be referred to Legal or R1 RCM for further actions.

• Stay informed about updates in payer policies and contract provisions.

⛳️ Requirements

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

• Relevant state licensure is required for the work performed.

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

• Preferred 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.

• Extensive subject-matter expertise in major national and regional payer environments, including UHC, BCBS, Cigna, Aetna, and Humana.

• Experience with vendor ecosystem integrations, particularly R1 RCM.

🏝️ Benefits

• Eligible for an annual bonus incentive.

• Comprehensive health coverage, including medical, dental, vision, prescription coverage, and HSA/FSA options.

• Employer-matched 403(b).

• Planning and hardship resources.

• Disability and life insurance.

• Pro-rated paid time off (PTO) and holidays.

• Ascension-paid tuition (Vocare).

• Tuition reimbursement.

• Ongoing professional development and online learning opportunities.

• Employee Assistance Program.

• Counseling and peer support services.

• Spiritual care and stress management resources.

• Parental leave support.

• Adoption assistance and family benefits.

• Optional legal and pet insurance.

• Transportation savings.