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Manager of Revenue Cycle Operations

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Quick Summary

Overview

ABOUT: Cardiovascular Services of America (CVAUSA) is the largest private and independent cardiology network in the United States.

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OtherManager

ABOUT: Cardiovascular Services of America (CVAUSA) is the largest private and independent cardiology network in the United States. Our inclusive and diverse network brings together top cardiovascular specialists and thought leaders who offer regional perspectives and a broad strategic vision for the future of patient care.

WHO WE ARE AND WHAT WE DO:
Headquartered in Orlando area, Cardiovascular Associates of America aims to bring the best cardiovascular physicians in one network with the common mission of saving lives, reducing costs, and improving patient care through clinical innovation. Through CVAUSA’s physician-centered practice management model, physicians drive clinical care and their practice culture, while benefiting from the business expertise and shared resources available through CVAUSA for better patient outcomes.

Position Summary
The Manager of Revenue Cycle Operations is responsible for overseeing operational performance across core revenue cycle functions to ensure accurate claim submission, compliant billing practices, timely reimbursement, and optimal financial performance.
This role provides leadership and oversight across middle-cycle and back-end revenue cycle operations including charge entry, coding coordination, claim submission, billing, payment posting, denial management, patient collections, and revenue integrity initiatives. The Manager works collaboratively with clinical, operational, and finance leadership to improve reimbursement outcomes, operational efficiency, revenue capture, and overall financial performance.
Percentage of Time Allocation: 50% Vendor Management / 50% Internal Revenue Cycle Operations

Duties and Responsibilities
Charge Entry & Coding Operations

Oversee charge capture and professional charge entry processes.
Ensure coding accuracy and compliance with payer requirements.
Monitor charge lag and support timely charge entry.

Claim Submission & Billing

Oversee claim preparation, claim scrubbing, and submission workflows.
Ensure claims are submitted timely and accurately according to payer guidelines.
Monitor claim edits and system workflows to support clean claim submission.

Payment Posting & Reconciliation

Oversee ERA and manual payment posting processes.
Ensure payment reconciliation accuracy.
Identify and escalate payer payment variances,

Accounts Receivable & Denial Management

Manage insurance accounts receivable and denial resolution processes.
Monitor payer trends and implement corrective actions to reduce denials.
Support timely follow-up on unpaid claims.

Patient Financial Services

Oversee patient balance collections and refund processes.
Manage early-out vendors and bad debt placement processes.
Ensure compliance with refund policies and patient financial regulations.

Revenue Integrity

Monitor charge capture accuracy and revenue reconciliation.
Identify revenue leakage and implement operational improvements.
Support revenue cycle performance monitoring and reporting.

Accounts Receivable Vendor Management (50%)

Serve as the primary point of contact and relationship manager for all outsourced Accounts Receivable vendors and business partners.
Establish performance expectations, service level agreements (SLAs), and key performance indicators (KPIs) to ensure vendor accountability.
Conduct regular vendor performance reviews focused on cash collections, aging reduction, denial resolution, productivity, quality, and turnaround times.
Monitor and analyze AR vendor performance metrics, identifying trends, risks, and opportunities for improvement.
Partners with vendors to develop and execute action plans to reduce aged AR, improve collection rates, and accelerate cash flow.
Ensure compliance with organizational policies, payer requirements, contractual obligations, and regulatory standards.
Facilitate ongoing communication between internal stakeholders and vendors to resolve operational issues and remove barriers to performance.
Review and approve vendor invoices, evaluate return on investment, and recommend staffing or outsourcing adjustments as needed.
Provide executive-level reporting and recommendations regarding vendor performance, AR trends, and revenue cycle optimization opportunities.

Performance Accountability / Key Performance Indicators
Staff Performance

Staff productivity metrics
Quality assurance monitoring

Charge Capture

Charge entry accuracy rate
Charge entry timeliness

Billing Performance

Claim rejection and edit rate
First-pass claim acceptance rate
Claim submission timeliness

Revenue Cycle Quality

Rework or correction rate
Denial rate and resolution turnaround time

This job description summarizes the primary duties of the position and is not intended to be all-inclusive. Duties may change at management’s discretion
Qualifications and Skills
Education

Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or a related field preferred.
Professional certification such as CPB, CPC, CRC or CHAM is preferred but not required

Experience

Minimum 5 years of experience in healthcare revenue cycle
Minimum 2 years of leadership or supervisory experience
Experience working in a physician practice or specialty clinic preferred.
Experience with AthenaOne, NextGen, eClinicalWorks, or similar practice management systems
preferred.

Knowledge & Skills

Comprehensive knowledge of healthcare revenue cycle operations including patient access, charge capture, billing, payment posting, accounts receivable, and patient financial services.
Knowledge of payer reimbursement methodologies including Medicare, Medicaid, and commercial insurance plans.
Familiarity with CPT, HCPCS, and ICD-10 coding fundamentals and claim submission requirements.
Understanding of point-of-service collections, patient financial counseling, and insurance benefit structures.
Ability to lead and develop operational teams across patient access and revenue cycle functions.
Strong analytical skills with the ability to interpret revenue cycle performance metrics and operational data.
Experience utilizing healthcare EMR and practice management systems (e.g., AthenaOne, eClinicalWorks, NextGen) and payer portals.
Knowledge of healthcare compliance requirements including HIPAA, documentation standards, and billing regulations.
Strong communication, collaboration, and problem-solving skills to support cross-functional operational improvement.