Revenue Manager – Pediatrics / Adult Ambulatory

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Oversee the activities of staff involved in charge capture, coding, charge entry, insurance follow-up, reimbursement analysis, and other PRMO functions.

• Evaluate staff performance in areas such as scheduling, registration, clinic check-in, and clinic collections.

• Create and utilize reports to monitor financial and operational performance in the revenue cycle.

• Assess and propose updates for the charge master and charge-capture documents.

• Identify, analyze, and address revenue cycle issues while implementing solutions for improvement.

• Provide education and training for providers and staff regarding coding and revenue cycle topics.

• Act as a liaison with PRMO, DUHS, Duke Health Integrated Practice, clinical leadership, and third-party payers.

• Investigate and apply payer regulations and guidelines.

• Handle revenue cycle inquiries, KPIs, reimbursement changes, and ServiceNow tickets.

• Serve as a knowledge resource for Epic Systems related to charge capture, reconciliation, corrections, and billing workflows.

• Resolve accounts within Charge Router, Charge Review, Claim Edit, and Follow-Up work queues.

• Foster collaboration in revenue cycle initiatives, strategic planning, workgroups, communications, and training.

• Oversee projects aimed at revenue enhancement and compliance, including action plans, timelines, root-cause analyses, and cross-functional teams.

• Coordinate the setup and modifications of Maestro Care for new services and validate billing functions post go-live.

• Develop optimal workflows and system enhancements to boost revenue cycle performance.

⛳️ Requirements

• Bachelor’s degree is mandatory.

• A minimum of 6+ years of pertinent healthcare experience is required, ideally in Charge Integrity/Revenue Management.

• Proven leadership skills with the ability to effectively lead, motivate, and collaborate with hospital leadership.

• Exceptional oral and written communication abilities.

• Strong problem-solving, analytical, and technical troubleshooting skills.

• Ability to prioritize tasks and manage multiple projects simultaneously.

• Flexibility to work on a varied schedule.

• Strong research and documentation abilities.

• Capability to work independently.

• Intermediate to expert proficiency in Microsoft Excel, PowerPoint, Teams, Word, Visio, and Outlook.

• Preferred qualifications include coding certification (e.g., CCS, CPC, RHIA, RHIT), HFMA CHFP, CRCR, or BSN RN.

🏝️ Benefits

• Equal Opportunity Employer.

• Commitment to fostering collaboration, innovation, creativity, and a sense of belonging.

• Information and provisions for reasonable accommodation are available.

• Flexible scheduling options.