Revenue Cycle Manager

This is a fully remote position, open to applicants in Kansas, +1 more state.

📋 Description

• Lead and manage the daily operations of a remote Central Billing Office team consisting of around 25 employees.

• Supervise billing processes for over 45 Skilled Nursing Facilities and 5 Senior Living Medicaid Waiver communities across several states.

• Set expectations for billing precision, punctuality, productivity, account follow-up, documentation, and accountability.

• Ensure claims are submitted accurately and on time while prioritizing and escalating unresolved issues.

• Oversee team workloads, performance metrics, and productivity levels.

• Collaborate with team leaders to identify performance issues, knowledge gaps, and training requirements.

• Provide coaching, training, and technical assistance to billing staff and those handling denial resolutions.

• Assist with the recruitment, onboarding, training, and professional development of employees.

• Act as a subject-matter expert in Skilled Nursing Facility claims and reimbursement processes.

• Evaluate complex SNF claims to detect billing, reimbursement, or payment discrepancies.

• Offer technical expertise on unusual or intricate claim matters.

• Stay updated on evolving payer and regulatory standards.

• Address and resolve complex Medicare, Medicaid, Managed Care, and commercial insurance denials.

• Examine denial patterns and pinpoint root causes and systemic reimbursement challenges.

• Analyze payer contracts and reimbursement terms.

• Support issues related to payers, contracting, credentialing, and payer relations.

• Engage in and provide leadership for the Triple Check process.

• Train facility Business Office Managers and staff on the Triple Check process and claim accuracy.

• Monitor billing, revenue, cash collections, accounts receivable, denial activities, payer performance, and facility trends.

• Investigate adverse revenue and cash trends, cash shortfalls, revenue leakage, and reimbursement risks.

• Report significant billing, payer, denial, revenue, and cash issues to Revenue Cycle and senior leadership.

• Collaborate with facility Business Office Managers, Administrators, Regional Directors of Operations, and Regional Vice Presidents.

• Identify facilities in need of additional Revenue Cycle support.

• Create targeted educational initiatives and suggest process enhancements for recurring billing and reimbursement challenges.

• Operate independently as a vital extension of the Director of Revenue Cycle Management.

⛳️ Requirements

• Required: Expert-level knowledge of Skilled Nursing Facility claims and reimbursement.

• Extensive hands-on experience with SNF billing and resolving complex claims.

• Strong understanding of Medicare SNF billing requirements and reimbursement standards.

• In-depth knowledge of Medicaid, Medicare Advantage/Managed Care, Medicaid Managed Care, commercial insurance, and other third-party payer billing in the SNF context.

• Proven ability to independently review and resolve complex SNF claims.

• Comprehensive understanding of how census, payer information, eligibility, authorizations, MDS/PDPM/HIPPS, clinical data, rates, ancillary services, contracts, and other data influence SNF claims.

• Strong familiarity with claim edits, rejections, denials, adjustments, corrections, underpayments, and reimbursement resolutions.

• Ability to identify the root causes of claim and reimbursement issues.

• Working knowledge of payer contracts and the capability to interpret contract terms affecting billing and reimbursement.

• Experience with the Triple Check process and SNF claim validation.

• Demonstrated leadership experience in Revenue Cycle, billing, collections, denial management, or a related field.

• Experience managing centralized, remote, and/or multi-facility Revenue Cycle operations.

• Strong analytical and critical thinking abilities.

• Exceptional attention to detail.

• Strong organizational and prioritization skills.

• Ability to juggle multiple competing priorities across a large facility portfolio.

• Capacity to work effectively and make sound decisions in high-pressure environments.

• Excellent written and verbal communication skills.

• Ability to effectively communicate with frontline employees, facility leadership, regional leadership, corporate departments, and senior executives.

• High level of proficiency with Microsoft Excel and Revenue Cycle reporting and analysis.

• Preferred: Significant experience with PointClickCare (PCC).

• Preferred: Experience managing a large remote Central Billing Office.

• Preferred: Experience overseeing billing operations across multiple states.

• Preferred: Experience leading or supporting denial resolution teams.

• Preferred: Experience with Medicaid Waiver billing and Senior Living reimbursement.

• Preferred: Experience with payer contracting, credentialing, or payer relations teams.

• Preferred: Experience providing Revenue Cycle education to facility Business Office Managers and Administrators.

🏝️ Benefits

• Advanced Pay

• Financial Literacy Classes

• Employee Assistance Program providing Mental Health Resources, Legal Guidance, Financial Information, and more!

• Child Care Discount

• Health Insurance

• Dental Insurance

• Vision Insurance

• Life Insurance

• 401(k) for Eligible Locations

• Tuition Reimbursement

• Paid Time Off

• Holiday Pay

• Exclusive Tutera Perks

• Tutera University

• Advancement Opportunities

• Competitive starting wage

• Stability from a family-owned company established in 1985