Job Description
Job DescriptionSenior Manager, Revenue Cycle
About the Role
Heritage Health Network is seeking an experienced Senior Manager, Revenue Cycle to lead our end-to-end Revenue Cycle Management (RCM) operations. Reporting directly to the CEO, you'll oversee billing performance, denial management, accounts receivable, payer compliance, and a team of Revenue Cycle professionals across multiple Medi-Cal managed care contracts.
This is a hands-on leadership role. Current RCM billing experience is required, and you must be able to step into billing operations when needed.
What You'll Do
- Lead the Revenue Cycle team, including the Revenue Cycle Supervisor and Billing Coordinators.
- Own revenue cycle performance, including clean claim rate, denials, timely filing, and AR aging.
- Oversee denial management, appeals, payer escalations, and reimbursement strategies.
- Lead month-end close activities, AR reconciliation, and payer reporting.
- Partner with Clinical Operations to ensure documentation accuracy and billing compliance.
- Build and present revenue cycle performance reports and dashboards.
- Drive process improvements to maximize reimbursement and operational efficiency.
- Support audits, payer reviews, and compliance initiatives.
- Coach, mentor, and develop a high-performing billing team.
- Step into billing operations when needed to support claims, denials, and AR follow-up.
RequirementsRequired
- Bachelor's degree in Business, Healthcare Administration, Health Information Management, or related field (equivalent experience considered).
- 5+ years of hands-on Revenue Cycle Management experience.
- 2+ years of leadership experience managing billing teams.
- Strong knowledge of claim submission, denials, appeals, AR, and Medi-Cal managed care billing.
- Experience with Office Ally, Availity, eClinicalWorks (eCW), Microsoft Excel, and Google Workspace.
- Experience with ECM, CalAIM, and managed care programs.
Preferred
- Experience with IEHP, Molina, CalOptima, Health Net, and Anthem payer portals.
- Power BI experience.
- Experience with capitated and per-encounter billing models.
- CPB, CRCR, or other Revenue Cycle certification.
Benefits
- Medical, Dental & Vision Insurance
- Paid Time Off & Company Holidays
- Competitive Compensation
- Remote Work Flexibility
- Professional Growth & Leadership Development Opportunities