Revenue Cycle Manager

$90,000 - $115,000/Yr

Re Pharmacy - Irvine, CA

Full-time - Mid Level

Irvine, CA

Health and Personal Care Retailers

About the position

The Revenue Cycle Manager oversees reimbursement processes within pharmacy and infusion center operations, providing leadership and managing productivity and financial performance. The role involves developing revenue cycle strategies, ensuring compliance with guidelines, and maximizing reimbursement through effective billing and collections management.

Responsibilities

• Oversee reimbursement processes within pharmacy and infusion centers.
• Manage billing and collections team and day-to-day operations in the revenue cycle center.
• Develop and implement revenue cycle strategies and intake protocols.
• Ensure financial targets are met and aligned with organizational objectives.
• Review new referrals for profitability and verify patient eligibility.
• Maximize reimbursement through timely and accurate claims submission.
• Monitor reimbursement activity and provide trend reports to senior management.
• Track key performance indicators in reimbursement and work with supervisors to improve service levels.
• Ensure compliance with company, Medicare, Medicaid, and payor guidelines.
• Anticipate and communicate legislative and regulatory changes impacting billing policies.
• Complete required projects and reports as directed by the COO.
• Audit billing and collections KPIs for accuracy and timelines.
• Foster a positive work environment and build team morale.
• Develop, coach, and manage staff through training and performance feedback.

Requirements

• Bachelor's degree in Business Administration or Health Care Informatics preferred.
• At least 4 years of healthcare reimbursement/billing experience with a Bachelor's degree, or 7 years with a high school diploma.
• At least 2 years of experience directly managing people.
• Experience in identifying operational issues and implementing strategies to resolve them.