Edgewater Health · 2 days ago
Revenue Cycle Manager
Gary, IN
Full-time
Onsite
Senior Level
5+ years expEdgewater Health is dedicated to providing high-quality primary care, addictions treatment, and mental health services. The Revenue Cycle Manager is responsible for overseeing and optimizing the organization’s revenue cycle operations, ensuring compliance with regulations and efficient financial transactions related to patient services.
Health CareMental HealthPharmaceuticalPrimary and Urgent CareRehabilitation
Responsibilities
Oversee all aspects of the revenue cycle, including patient registration, charge capture, coding, billing, claims submission, payment posting, and collections
Monitor and evaluate performance indicators such as accounts receivable aging, denial rates, and collection ratios to ensure efficient cash flow and revenue optimization
Develop and implement policies and procedures to support compliant and efficient revenue cycle operations
Coordinate with clinical and administrative departments to ensure proper documentation and charge capture for services across all programs (primary care, behavioral health, and substance use treatment)
Analyze and resolve reimbursement issues, denials, and underpayments; lead root cause analyses to prevent recurrence
Maintain current knowledge of payer requirements, billing regulations, and compliance standards (Medicare, Medicaid, Managed Care, and other third-party payers)
Collaborate with the Compliance Officer to ensure adherence to HIPAA, OIG, and CMS guidelines
Prepare monthly, quarterly, and annual reports on revenue performance and key financial indicators for executive leadership
Lead, train, and supervise billing and revenue cycle staff, fostering a culture of accountability, collaboration, and continuous improvement
Partner with IT and EHR teams to ensure billing and reporting systems function effectively and support workflow efficiency
Participate in annual audits, grant reporting, and financial reviews as requested
Support the organization’s mission and values through ethical financial practices and a focus on patient-centered service delivery
Perform other duties as assigned
Qualification
Required
Education- bachelor's degree in healthcare administration, finance, accounting, business, or related field required
Minimum of five years of progressive experience in healthcare revenue cycle management required
Experience with Medicaid, Medicare, and managed care billing and reimbursement required
Demonstrated knowledge of CPT/ICD-10 coding, payer rules, and managed care reimbursement
Preferred
Master's degree preferred
Experience in behavioral health, primary care, or substance use treatment billing strongly preferred
Familiarity with value-based payment models and integrated care billing preferred
Strong leadership and team building skills
Excellent analytical, problem solving, and decision-making abilities
In-depth knowledge of payer contracting, claims processing, and reimbursement methodologies
Effective communication and interpersonal skills to work collaboratively across departments
Ability to manage multiple priorities and meet deadlines in a fast-paced healthcare environment
High degree of integrity, professionalism, and commitment to confidentiality
Company
Edgewater Health
Edgewater Health is an organization that provides primary care, mental health, addiction and pharmacy services.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Michael LaBroi
Chief Information Officer
Ralynn Crockett, MPA-MHRM
Chief Human Resources Officer
Recent News
Government Technology US
2025-07-15
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