Cycle Revenue Manager

Job Description

Job Description

MINIMUM QUALIFICATIONS:

● Associates or bachelor's degree in healthcare administration, Business, Finance, Accounting, or related field preferred.

● Equivalent experience in healthcare revenue cycle management will be considered.

● Minimum of 3–5 years of revenue cycle or medical billing experience required.

● Minimum of 2 years of supervisory or management experience preferred.

● Experience in behavioral health and/or substance use disorder treatment preferred.

● Experience with Ohio Medicaid and managed care billing strongly preferred.

● Strong understanding of:

○ Behavioral health billing

○ Insurance authorization processes

○ Claims management

○ Medicaid and commercial payer requirements

● Knowledge of ASAM levels of care preferred.

● Proficiency with Electronic Health Record (EHR) and billing systems.

● Strong analytical, organizational, and problem-solving skills.

● Excellent communication and leadership abilities.

● Ability to maintain confidentiality and handle protected health information appropriately.

● Certified Professional Biller (CPB)

● Certified Revenue Cycle Representative (CRCR)

● Certified Professional Coder (CPC)

● Qualified Mental/Behavioral Health Specialist

● CPR Certification

● Be knowledgeable of and adhere to all pertinent federal, state, and local laws, standards of the Ohio Department of Mental Health, and appropriate professional ethical standards

● Complies with agency policies and procedures, COA regulations, federal and state requirements, and educational/certification/registry requirements

● The ability to communicate effectively verbally and in writing

● Strong organizational and documentation skills

● Ability to meet agency requirements for criminal background check

● Ability to function as part of an organization by working with others and by adhering to established policies and procedures

● Prolonged periods of sitting and computer use.

● Ability to communicate effectively in person, by phone, and electronically.

● Occasional lifting up to 15 pounds.

DUTIES AND RESPONSIBILITIES:

● Maintains appropriate documentation, including internal personnel records, operating reports and specific duties and analyses.

● Maintain compliance with:

○ HIPAA regulations

○ Medicaid and commercial payer guidelines

○ COA and/or Joint Commission standards

○ Federal and Ohio billing requirements

● Achieve satisfactory results on internal and external billing audits.

● Ensure documentation supports billed services and medical necessity requirements.

● Develop and maintain standardized billing workflows and procedures.

● Improve revenue cycle efficiency and reduce process bottlenecks.

● Identify trends, root causes, and corrective action plans for denials or payment delays.

● Produce timely and accurate monthly revenue cycle reports for leadership.

● Provide effective supervision, training, and performance management for revenue cycle staff.

● Maintain appropriate staffing productivity and accountability standards.

● Foster positive collaboration between admissions, clinical, utilization review, and finance departments.

● Support employee retention, engagement, and professional development.

● Maintain professional and collaborative relationships with payers, vendors, clients, and internal departments.

● Respond promptly and professionally to billing inquiries and escalations.

● Promote ethical billing practices and organizational integrity.

● Ensure timely acquisition and renewal of payer authorizations.

● Minimize authorization lapses and retroactive denials.

● Collaborate with clinical/utilization review teams to maximize approved lengths of stay and reimbursement opportunities.

● Ensure claims are submitted within established timely filing requirements.

● Maintain high accuracy rates in billing and coding submissions.

● Monitor turnaround times for:

○ Claim submission

○ Denial resolution

○ Appeals processing

○ Payment posting

● Reduce payer rejections and recurring billing errors.

● Maintain strict professional boundaries at all times

● Maintain target Days in Accounts Receivable (A/R) as established by organizational goals.

● Achieve and sustain targeted clean claim rate percentage.

● Reduce and monitor claim denial rates.

● Improve overall collections rate and reimbursement accuracy.

● Monitor and reduce aging balances in:

○ 30-day A/R

○ 60-day A/R

○ 90+ day A/R

● Meet monthly cash collection and revenue targets

Company Description

We assist individuals with making lifestyle changes through our continuum of care. We empower diverse individuals to achieve wellness, mental health, and recovery goals. We foster a safe therapeutic community focused on individual recovery — promoting autonomy and efficacy.

Bridging the gap between understanding and application.

Company Description

We assist individuals with making lifestyle changes through our continuum of care. We empower diverse individuals to achieve wellness, mental health, and recovery goals. We foster a safe therapeutic community focused on individual recovery — promoting autonomy and efficacy.\r\n\r\nBridging the gap between understanding and application.