Manager, Revenue Cycle chez Southeastern Michigan Health Association

Description

LOCATION: Wayne County Healthy Communities - Hamtramck, MI 48212

POSITION SUMMARY: The Revenue Cycle Manager will be responsible for overseeing and managing all aspects of the revenue cycle process for the Federally Qualified Health Center (FQHC). This includes ensuring efficient, accurate, and timely billing and collections, optimizing revenue cycle processes, managing a team, and ensuring compliance with federal, state, and payer-specific regulations.

Established in 2012, Wayne County Healthy Communities (WCHC) is a not-for-profit community health center providing medical, dental, OB/GYN, pediatric, community outreach, and behavioral health services across Wayne County. Our mission at Wayne County Healthy Communities is to provide high-quality health care to all patients in a patient-centered medical home.

Key Responsibilities:

1. Revenue Cycle Management:

• Oversee the entire revenue cycle process from patient intake through billing and collections.
• Ensure timely and accurate submission of claims to insurance carriers and government programs such as Medicaid, Medicare, and private payers.
• Review and monitor coding compliance to ensure all services are accurately documented and billed.
• Monitor charge capture and ensure proper documentation for services provided.
• Resolve claim denials and work to reduce rejections.

2. Team Leadership and Development:

• Supervise and manage the revenue cycle team, including billing, coding, and collections staff.
• Provide training and professional development to staff to ensure knowledge of current revenue cycle practices, regulations, and      payer requirements.
• Set performance goals and conduct regular performance reviews.

3. Financial Reporting and Analysis:

• Prepare and analyze monthly, quarterly, and annual reports related to revenue cycle metrics such as collection rates, denials, aging reports, and reimbursement trends.
• Work with leadership to develop revenue cycle improvement strategies.
• Provide regular updates on revenue cycle performance to the executive team.

4. Compliance and Audits:

• Ensure compliance with federal, state, and payer regulations, including HIPAA, billing, coding, and documentation      requirements.
• Monitor audit trends and implement corrective actions where necessary.
• Stay up to date with regulatory changes and ensure the revenue cycle department is compliant.

5. Process Improvement:

• Identify opportunities for workflow improvements to enhance the efficiency of the revenue cycle process.
• Work with IT and operations teams to implement new technologies or systems that optimize revenue cycle operations.
• Develop and implement policies and procedures for revenue cycle management.

6. Payer Relations and Contract Management:

• Manage relationships with payers and insurance companies, including negotiating contracts and resolving payment disputes.
• Stay informed on payer policies, including rate changes, coding requirements, and reimbursement schedules.

7. Budgeting and Forecasting:

• Assist in budget preparation related to revenue cycle operations.
• Provide financial forecasting based on analysis of current trends and performance.

Qualifications:

Education and Experience:

• Bachelor's degree in healthcare administration, Finance, Business, or a related field (required).
• Minimum of 5 years of experience in revenue cycle management, with at least 2 years of experience in a leadership or managerial role in a healthcare setting, preferably within a Federally Qualified Health Center (FQHC).
• Strong knowledge of Medicare, Medicaid, commercial insurance, and healthcare billing practices.
• Knowledge of healthcare revenue cycle software and Electronic Health Record (EHR) systems.

Skills and Abilities:

• Strong leadership and team management skills.
• Exceptional problem-solving and analytical skills.
• Excellent communication skills, both written and verbal.
• Strong understanding of coding, billing, and compliance regulations, including HIPAA.
• Ability to manage multiple priorities and meet deadlines.
• Proficient in Microsoft Office Suite (Excel, Word, PowerPoint) and revenue cycle management software.

Certifications:

• Certification as a Professional Coder (CPC) or Certified Revenue Cycle Representative (CRCR) preferred but not required.

Physical Requirements:

• Ability to sit for extended periods and use a computer.
• Ability to communicate effectively in both person and over the phone.

Salary: $70,000 yearly 

Employment Type: Full-Time or Part-Time

Classification: Exempt (salaried)

Benefits:

• Health insurance, Dental insurance, and Vision insurance
• Paid time off (Holidays, Vacation, Personal, & Sick time)
• 401a & 403b (Retirement plans)
• Long Term Disability 
• Employee assistance program
• Group Life Insurance
• Various Voluntary Benefit Option
   

Application Deadline: October 31, 2025 

Please contact SEMHA HR Department @ (313) 873-6500 if you need assistance to upload resume, cover letter, and/or make application online.