CFS ยท 1 day ago
Senior Revenue Cycle Manager
Carver, MA
Full-time
Hybrid
Senior Level
$110K/yr - $112K/yr
5+ years expCFS is a healthcare organization seeking a Senior Revenue Cycle Manager to oversee billing and claims processing operations. The role involves managing high volumes of claims, resolving billing issues, and leading a team to improve revenue cycle performance.
Human ResourcesStaffing Agency
Responsibilities
Manage all aspects of the revenue cycle, including preparing, submitting, and following up on claims to insurance companies, government payers, and third-party entities
Collaborate with physicians, insurance companies, and internal departments to resolve billing issues, ensure accurate coding, and improve revenue cycle performance
Ensure accurate medical coding in compliance with ICD-10, CPT, and payer guidelines
Conduct regular chart audits to ensure documentation compliance and billing accuracy
Submit prior authorization requests to insurance payers for procedures and treatments
Oversee processing of high-volume claims, ensuring timely and accurate submissions aligned with payer requirements and contract terms
Review and resolve insurance denials; lead appeals to recover revenue
Analyze and manage insurance contract terms to ensure billing practices align with reimbursement structures and coverage policies
Develop strategies to reduce claim denials and improve first-pass claim accuracy
Conduct audits on billing and claims submission processes for compliance
Manage and mentor a large billing team and credentialing staff, providing training, support, and performance management
Develop and implement quality metrics and performance benchmarks for the billing team
Provide ongoing training on insurance policies, payer coverage, claims processing, denial management, and best practices
Monitor and assess team performance using KPIs; conduct reviews and implement corrective actions
Prepare and present detailed reports on denial rates, claim accuracy, revenue cycle performance, and appeals outcomes
Ensure team stays current with payer policy changes, insurance guidelines, and healthcare regulations
Build and maintain strong relationships with insurance payers to ensure smooth claims resolution
Qualification
Required
Bachelor's degree in Healthcare Administration, Business, Finance, or related field (preferred)
5+ years of revenue cycle experience, with at least 3 years in management
Strong understanding of insurance coverage policies, prior authorizations, and contract management
Extensive experience managing insurance denials, appeals, and negotiating with payers
Proven leadership experience managing large billing teams in a fast-paced environment
Proficiency in billing software, practice management systems, and EHR platforms
In-depth understanding of coding, billing procedures, and the full revenue cycle
Excellent problem-solving and organizational skills
Familiarity with HIPAA regulations and compliance standards
Preferred
Certification in Medical Billing and Coding (CPC, CBCS) or Revenue Cycle Management (CHFP, CRCR)
Experience in Specialty practice management strongly preferred
Benefits
Competitive benefits
Company
CFS
Founded by CPA firms in 1994, Creative Financial Staffing has spent over 30 years helping job seekers and employers succeed.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Dan Casey
CEO, Founder
Company data provided by crunchbase