The Revenue Cycle Manager oversees daily operations within the revenue cycle department to ensure accurate, efficient, and compliant billing, coding, and collections processes. This role leads claim submissions for both DME and healthcare services, supports process improvement initiatives, and collaborates with clinical, financial, and administrative teams to optimize reimbursement and reduce denials. The manager ensures adherence to organizational policies, payer requirements, and regulatory guidelines.
Manage day-to-day workflows for billing, coding, charge capture, claims submission, payment posting, and accounts receivable follow-up.
Monitor work queues, productivity benchmarks, and aging reports to ensure timely processing.
Identify and resolve issues related to claim errors, coding discrepancies, or missing documentation.
Ensure compliance with federal, state, and payer-specific billing regulations.
Analyze denial trends and collaborate with coding, clinical, and operational leaders to reduce preventable denials.
Develop and implement corrective action plans to improve clean-claim rates.
Assist with appeals processes and payer communication as needed.
Monitor key metrics such as net collection rate, bad debt, and denial rates.
Ensure all processes align with HIPAA regulations and organizational compliance standards.
Review coding and billing accuracy; coordinate audits and corrective actions.
Maintain up-to-date knowledge of payer guidelines, CMS updates, and industry best practices.
Prepare and present regular performance reports for leadership.
Communicate policy updates, procedural changes, and payer information to staff.
Collaborate with internal departments to resolve workflow barriers and improve revenue cycle performance.
Support broader Market Access team in patient communications related to coverage decisions, expected out-of-pocket obligations, and financial relief program
May be assigned additional responsibilities to meet departmental and organizational priorities.
5-7 years of experience in healthcare revenue cycle operations (billing, coding, AR, or related functions).
High school diploma or GED required; AA, BA/BS, or healthcare-related certification preferred.
Strong communication and interpersonal skills, with the ability to communicate clearly with patients, healthcare providers, payers, and internal stakeholders
Strong understanding of medical billing, coding (ICD-10, CPT, HCPCS), and payer reimbursement methodologies.
Excellent leadership, communication, and interpersonal skills.
Ability to analyze data, identify trends, and recommend process improvements.
Proficiency with EHR/EMR and practice management systems (Niko, Canvas, Salesforce and outside clearinghouse).
Strong organizational skills with attention to detail and deadlines.
What We Offer
Please note that the salary information is a general guidance only. Kandu Health, Inc. considers factors such as scope and responsibilities of the position, candidate’s work experience, education/training, key skills and internal parity, as well as location, market and business considerations when extending an offer.
Kandu Health is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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