Revenue Cycle Manager

About PURE

Pure Infusion Suites is a fast-growing healthcare start-up, recognized as the fastest-growing company in Utah as of October 2024. Our success comes from our remarkable team, shared values, and a supportive culture that shows in every interaction, whether with patients in our clinics or with insurance companies and vendors at our corporate headquarters. If you are detail-oriented, self-directed, and passionate about ensuring claims are processed quickly and accurately, this could be the perfect role for you.

OUR CORE VALUES
We live by four core values that define our culture and guide our hiring:

·         People-obsessed

·         Passionate

·         Builder

·         Grateful

Revenue Cycle Manager Position Summary:

The Revenue Cycle Manager leads the daily operations of Billing, and Collections, while managing accounts receivable across Medicare, Medicaid, commercial payers, and patient balances. The role oversees all back-end revenue cycle functions—including claims submission, payment posting, insurance follow-up, denial management, patient collections, and A/R recovery—to ensure accurate billing, timely reimbursement, regulatory compliance, and strong cash flow.

Key Responsibilities

· Develop and implement policies and procedures to ensure accurate and timely billing processes.

· Supervise collection efforts and provide leadership to Business Office Managers and staff.

· Monitor reimbursement trends, prepare analytical reports with trend assessments, and present findings to senior management.

· Stay informed on legislative, regulatory, and payer policy changes; anticipate impacts and communicate updates to relevant teams.

· Ensure compliance with company and payer guidelines through routine audits and process reviews.

· Forecast monthly collections and report projections to senior leadership.

· Collaborate with credentialing teams to minimize revenue disruptions at new and existing sites.

· Recruit, develop, coach, and manage staff, including setting objectives, providing orientation, communicating expectations, and applying progressive discipline as needed.

· Develop cross-functional strategies to exceed cash collection targets, reduce days in accounts receivable (AR), and minimize denial and adjustment rates.

· Track and report key revenue cycle performance indicators (KPIs) to leadership and stakeholders.

· Establish systems and processes to ensure compliance with contract requirements, including claim submission, documentation, fee schedules, credentialing, and site enrollments.

· Provide oversight (in collaboration with financial leadership) on general ledger close activities related to revenue, AR, and billing.

· Maintain contract controls, policies, and procedures in alignment with state/federal laws, compliance plans, and HIPAA regulations.

· Monitor collections against established goals to maximize cash flow and continuously assess claim submission processes for improvements.

· Oversee analysis, recording, and trending of revenue adjustments, write-offs, and denials; provide management with recommendations to reduce future occurrences.

Required Knowledge, Skills, and Abilities

· Experience with R2, Office Ally and WeInfuse systems highly preferred

· Excellent communication, collaboration, and interpersonal skills to optimize departmental processes and outcomes.

· Superior customer service orientation.

· Advanced proficiency in Microsoft Office (Word, Excel, Outlook).

· Strong organizational, analytical, and decision-making abilities.

· High computer literacy in PC environments.

· Professional written and verbal communication skills, including grammar and composition.

· Proactive, forward-thinking approach with strong problem-solving skills.

· Proven ability to meet productivity standards and performance metrics.

· Accurate and efficient data entry capabilities.

· Commitment to team goals and collaborative success.

Education, Experience, and Requirements

· Minimum of 10+ years of relevant experience in medical billing and revenue cycle management, preferably in specialty infusion therapy or complex outpatient services.

· Demonstrated experience delegating tasks and leading teams effectively.

· Bachelor’s degree in accounting, Finance, Healthcare Administration, or a related field preferred.

· Ability to meet U.S. employment eligibility requirements