Tsela Scientific Laboratories · 5 days ago
Revenue Cycle Manager
Greater Birmingham, Alabama Area
Full-time
Onsite
Senior Level
5+ years expTsela Scientific Laboratories is a growing clinical laboratory seeking a Revenue Cycle Manager to oversee and optimize the full revenue lifecycle. The role involves managing payer strategy, denial management, and ensuring revenue integrity while coordinating with an outsourced billing partner.
Hospital & Health Care
Responsibilities
Serve as the internal owner of the end-to-end revenue cycle, from test order through payment
Manage and audit outsourced billing vendor performance
Ensure accurate CPT/HCPCS coding, modifiers, and diagnosis linkage
Monitor net collection rate (NCR), days in A/R, denial rates, and first-pass yield
Identify denial trends by payer, test type, and ordering provider
Develop and execute appeal strategies for commercial and government payers
Coordinate clinical documentation to support medical necessity
Reduce preventable denials through workflow improvements
Interpret and implement payer medical policies (Medicare MACs, BCBS, Medicaid)
Serve as subject matter expert on lab reimbursement rules and coverage criteria
Partner with compliance and clinical leadership to mitigate audit risk
Assist in preparing for payer audits, recoupments, and post-payment reviews
Act as primary liaison with outsourced billing company
Hold regular performance reviews and data reconciliation meetings
Coordinate payer enrollment, credentialing, and contract updates
Support payer negotiations and reimbursement issue resolution
Provide executive-level reporting on revenue performance and risks
Forecast cash flow and identify revenue leakage
Recommend process improvements to improve clean claim rates
Support growth initiatives by assessing reimbursement viability of new tests
Qualification
Required
5+ years of revenue cycle experience in healthcare
2+ years of direct clinical laboratory billing or RCM experience
Strong knowledge of CPT / HCPCS coding
Strong knowledge of ICD-10 diagnosis requirements
Strong knowledge of Medicare, Medicaid, and commercial payer policies
Experience managing or auditing an outsourced billing vendor
Proven success improving collections and reducing denials
Strong analytical, organizational, and communication skills
Preferred
Experience with molecular diagnostics, toxicology, or infectious disease testing
Familiarity with BCBS medical policies and Medicare MAC guidance
Experience supporting payer audits or appeals
Background working with CLIA-certified laboratories
Compliance or regulatory knowledge (CMS, OIG risk awareness)
Benefits
Medical
Dental
Vision
Life
Disability
Other supplemental benefit options
Company
Tsela Scientific Laboratories
Founded in 2023, Tsela Scientific Laboratories is dedicated to enhancing patient care by delivering precise and timely diagnostic information to clinicians.
11-50 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase