Community Health Alliance (CHA) is seeking an experienced Revenue Cycle & Billing Manager to provide leadership and oversight of our healthcare revenue cycle operations. This is a key position responsible for ensuring accurate, timely, and effective billing and collections processes while maximizing reimbursement for services provided across our medical, dental, and behavioral health programs.
The Revenue Cycle & Billing Manager serves as a critical liaison between CHA, our contracted billing and collections partners, health plans, providers, and internal operational and fiscal teams. The ideal candidate brings strong healthcare revenue-cycle expertise, excellent analytical skills, and a working knowledge of FQHC reimbursement, Medicaid, Medicare, managed care, claims adjudication, denial management, and payer requirements.
This position requires significant healthcare revenue-cycle experience. Candidates should have demonstrated experience with healthcare claims, Medicaid/Medicare, denial management, reimbursement, accounts receivable, and payer processes. FQHC revenue-cycle experience, including knowledge of PPS and Wrap reimbursement, is strongly preferred.
If you are a revenue-cycle professional who enjoys solving complex billing issues, identifying opportunities to improve reimbursement, and partnering with others to strengthen financial performance, we would love to hear from you!
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Knowledge, Skills & Abilities
The successful candidate will demonstrate:
- Strong knowledge of the healthcare revenue cycle.
- Strong knowledge of claims processing and reimbursement.
- Knowledge of Medicaid, Medicare, CMS, and managed-care requirements.
- Knowledge of FQHC operations and reimbursement methodologies.
- Knowledge of medical, dental, and behavioral health billing.
- Knowledge of ICD-10-CM and CPT coding systems.
- Strong analytical and problem-solving skills.
- Ability to interpret financial, billing, and operational reports.
- Ability to identify trends and translate data into actionable recommendations.
- Strong vendor-management and relationship-management skills.
- Excellent communication and customer-service skills.
- Strong attention to detail and accuracy.
- Ability to work collaboratively with clinical, operational, fiscal, and administrative teams.
- Ability to maintain HIPAA compliance and patient confidentiality.
- Proficiency with Microsoft Office, spreadsheets, databases, email, and other business applications.
Required Qualifications
- Bachelor's degree in Business, Healthcare Administration, Finance, Revenue Cycle Management, or a related field or equivalent combination of education and relevant experience.
- Five (5) or more years of progressive healthcare billing, reimbursement, or revenue-cycle experience.
- At least three (3) years of supervisory or management experience.
- Demonstrated experience with healthcare claims processing, adjudication, denial management, accounts receivable, and collections.
- Working knowledge of Medicaid, Medicare, CMS, and managed-care reimbursement requirements.
- Experience working with electronic medical records and/or practice management systems.
- Demonstrated ability to analyze billing and financial reports and identify trends, discrepancies, and opportunities for improvement.
- Strong understanding of healthcare billing and reimbursement processes.
- Excellent written, verbal, analytical, and interpersonal communication skills.
- Strong organizational skills and the ability to manage multiple priorities and deadlines.
- Demonstrated ability to develop productive relationships with internal teams, vendors, and external partners.
- Ability to maintain strict confidentiality and HIPAA compliance.
