Revenue Cycle Manager (JR234261)

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Bronx, New York

Montefiore

<h4 class=""><strong>WHY TOP TALENT PICKS MONTEFIORE EINSTEIN&nbsp;<br /><br /></strong>Since its inception in 1884, Montefiore Einstein&rsquo;s mission has been to heal, to teach, to discover and advance the health of the communities we serve.<br /><br />Montefiore Einstein&rsquo;s state-of-the-art facilities include the&nbsp;<span class="">internationally-recognized</span>&nbsp;Children&rsquo;s Hospital at Montefiore Einstein and our Notable Centers of Excellence - Montefiore Einstein Center for Cancer Care, Montefiore Einstein Center for Heart and Vascular Care, Montefiore Einstein Center for Transplantation. Combined with a growing number of locations throughout the Bronx and Westchester County, Montefiore Einstein is the ideal organization to apply and hone your expertise.<br /><br /><span style="text-decoration: underline;"><a href="https://montefiore.wd12.myworkdayjobs.com/en-US/MMC/login" target="_blank" title="Candidate Home" rel="noopener noreferrer">Sign In</a></span>&nbsp;- Candidate Home<br /><span style="text-decoration: underline;"><a href="https://montefiore.wd12.myworkdayjobs.com/en-US/MMC/introduceYourself" target="_blank" title="Introduce Yourself " rel="noopener noreferrer">Introduce Yourself&nbsp;</a></span>-&nbsp;Please let us know about yourself so we can keep in touch about future job openings!<br /><br /><strong><span class="">NURSE&nbsp;RECRUITMENT&nbsp;HOTLINE:</span>&nbsp;<span class="">718-920-6697 (</span><span class="">Monday-Friday: 9am-4pm)&nbsp;&nbsp;</span></strong><br /><br /><strong>Check Out Our Employee&nbsp;<span style="text-decoration: underline;"><a href="https://healthymebenefits.com/" target="_blank" title="Benefits" rel="noopener noreferrer">Benefits</a></span></strong></h4> <h4 class="p1"><span style="text-decoration: underline;"><strong><a href="https://s3.us-east-1.amazonaws.com/vizi.vizirecruiter.com/MontefioreHealthSystem+RecruitingPractices.pdf" target="_blank" title="Safe Online Recruiting" rel="noopener noreferrer">Our Commitment to Safe Online Recruiting</a></strong></span></h4> https://www.montefiore.org/

keywords: position summary,pay rate,revenue cycle operations,billing compliance & regulatory oversight,denials management & revenue optimization,team leadership & staff development,provider & operational support,reporting & financial analysis,education,experience,skills,knowledge

Full time

$112,000.00-$140,000.00

Overview: The Revenue Cycle Manager is responsible for overseeing all facility revenue cycle operations for multiple Article 32 Behavioral Health Clinics at Montefiore. This role ensures accurate billing, collections, regulatory compliance, and optimal financial performance across addiction outpatient substance abuse, chemical dependency, psychiatry and psychology services. The manager partners closely with clinical leadership, finance, and operations to drive revenue integrity, reduce denials, and improve cash collections.&nbsp;
Responsibilities: <p><strong>Revenue Cycle Operations</strong>&nbsp;</p> <ul> <li>Oversee end-to-end revenue cycle functions, including charge capture, coding, billing, claims submission, payment posting, and A/R follow-up&nbsp;</li> </ul> <ul> <li>Ensure timely and accurate submission all facility claims&nbsp;</li> </ul> <ul> <li>Monitor key performance metrics (charges, collections, denial rates, lag days) and implement improvement initiatives&nbsp;</li> </ul> <ul> <li>Manage error logs, work queues and staff assignments to ensure efficient workflows and coverage&nbsp;</li> </ul> <p><strong>Billing Compliance &amp; Regulatory Oversight</strong>&nbsp;</p> <ul> <li>Ensure compliance with Article 32, OASAS, Medicaid, Medicare, Essential and commercial payer requirements&nbsp;</li> </ul> <ul> <li>Oversee billing documentation and coding accuracy for addiction, psychiatric and psychological services (E/M, psychotherapy, modifiers and add-on codes)&nbsp;</li> </ul> <ul> <li>Maintain audit readiness and respond to internal and external audits&nbsp;</li> </ul> <ul> <li>Develop and maintain billing and documentation policies aligned with regulatory guidance&nbsp;</li> </ul> <p><strong>Denials Management &amp; Revenue Optimization</strong>&nbsp;</p> <ul> <li>Analyze denial trends and implement corrective action plans&nbsp;</li> </ul> <ul> <li>Partner with billing vendor, coding, front-end, and clinical teams to address root causes (e.g., authorization, eligibility, documentation gaps)&nbsp;</li> </ul> <ul> <li>Drive improvements in clean claim rate and overall reimbursement performance&nbsp;</li> </ul> <ul> <li>Identify opportunities to optimize payer mix, coding utilization, and visit capture&nbsp;</li> </ul> <ul> <li>Attend various payor meetings to address systematic denial challenges&nbsp;</li> </ul> <p><strong>Team Leadership &amp; Staff Development</strong>&nbsp;</p> <ul> <li>Manage revenue cycle staff, including hiring, training, and performance oversight&nbsp;</li> </ul> <ul> <li>Provide ongoing education to staff, administration and providers on billing rules and workflow updates&nbsp;</li> </ul> <ul> <li>Establish productivity benchmarks and monitor team performance&nbsp;</li> </ul> <p><strong>Provider &amp; Operational Support</strong>&nbsp;</p> <ul> <li>Collaborate with clinic leadership and administration to improve timeliness of all providers in closing services&nbsp;&nbsp;</li> </ul> <ul> <li>Support onboarding of new providers, programs, and service lines (billing setup and workflows)&nbsp;</li> </ul> <ul> <li>Partner with front-end teams and clinical managers to ensure accurate registration, insurance verification, and authorization processes if required by the individual plan&nbsp;</li> </ul> <p><strong>Reporting &amp; Financial Analysis</strong>&nbsp;</p> <ul> <li>Prepare and present revenue cycle dashboards and KPIs to leadership&nbsp;</li> </ul> <ul> <li>Conduct variance analyses (volume, rate, payer mix) to identify performance drivers&nbsp;</li> </ul> <ul> <li>Support budgeting and forecasting processes&nbsp;</li> </ul> <p>&nbsp;</p>
Requirements: <p><strong>Education &amp; Experience</strong>&nbsp;</p> <ul> <li>Bachelor&rsquo;s degree required (Healthcare Administration, Finance, or related field preferred)&nbsp;</li> </ul> <ul> <li>5+ years of revenue cycle experience, including 2&ndash;3 years in a supervisory or management role&nbsp;</li> </ul> <ul> <li>Experience in Behavioral Health, Addiction, Psychiatry, or Article 31/32 clinics strongly preferred&nbsp;</li> </ul> <p><strong>Technical Knowledge</strong>&nbsp;</p> <ul> <li>Behavioral health CPT and HCPCS coding (E/M, psychotherapy, testing)&nbsp;</li> </ul> <ul> <li>Medicaid/Medicare/Essential/Commercial billing rules, including NYS Medicaid&nbsp;</li> </ul> <ul> <li>Article 32 regulatory requirements&nbsp;</li> </ul> <ul> <li>Epic, IMA, SMARTCloud or similar EMR/billing systems&nbsp;</li> </ul> <p><strong>Skills</strong>&nbsp;</p> <ul> <li>Strong analytical and problem-solving capabilities&nbsp;</li> </ul> <ul> <li>Ability to translate data into actionable insights&nbsp;</li> </ul> <ul> <li>Effective communication and stakeholder management&nbsp;</li> </ul> <ul> <li>High attention to detail with a focus on compliance and accuracy&nbsp;</li> </ul> <p>&nbsp;</p> <p><strong>Preferred Qualifications</strong>&nbsp;</p> <ul> <li>CPC, CPB, or similar certification&nbsp;</li> </ul> <ul> <li>Experience managing hospital billing (HB)&nbsp;</li> </ul> <ul> <li>Experience in an academic medical center or large health system&nbsp;</li> </ul>