"Revenue Cycle Manager - College of Dentistry"

Job Description

The College of Dentistry is seeking an experienced Revenue Cycle Manager. This position will be responsible for the strategic oversight and management of College of Dentistry revenue cycle operations. A key focus of this role is optimizing Electronic Data Interchange (EDI) workflows to ensure accuracy and efficiency across all revenue cycle functions, including: patient registration, insurance verification, patient payments, claims submission, insurance payment posting, and remittance processing. This role is critical to maintaining strong financial performance, ensuring regulatory compliance, and supporting a positive patient experience.

Duties:

• Oversees end-to-end revenue cycle operations across multiple departments and service lines, ensuring seamless workflow integration including charge capture, coding, payment posting, and denial management.
• Ensures accurate and efficient execution of patient registration, insurance verification, authorization, billing, and collections processes.
• Manages all aspects of Electronic Data Interchange (EDI), including claim submissions, eligibility verifications (270/271), claim status inquiries (276/277), electronic remittance advice (835), and electronic funds transfers (EFT).
• Collaborates with IT teams and EHR vendors to troubleshoot, optimize, and maintain EDI transaction workflows and interface functionality.
• Works closely with key stakeholders to ensure accurate documentation and coding of procedures in alignment with regulatory standards.
• Trains, supervises, and supports billing, front-desk, and collections staff, ensuring adherence to departmental policies and performance goals.
• Acts as the primary liaison between the billing department and academic units, aligning financial operations with educational program needs.
• Monitors, analyzes, and reports on key revenue cycle performance indicators (e.g., days in A/R, collection rate, denial rate), providing actionable insights to senior leadership.
• Directs claims submission and appeals processes, ensuring compliance with payer policies, Medicaid, Medicare, and other government programs.
• Partners with IT and compliance departments to ensure the accuracy, security, and regulatory compliance of EHR and practice management systems.
• Supports the financial and operational integration of new clinical programs or specialty services, including process development and staff training.
• Ensures all billing and financial operations comply with HIPAA, FERPA, CMS regulations, and internal institutional policies.
• Develops and implement strategies to improve billing processes and reduce claim denials and delays.
• Maintains and updates policies and procedures related to the revenue cycle.
• Performs other duties as assigned.

Job Requirements

Required Education: Bachelor's degree in Healthcare Administration, Business, Finance, or related field, AND: 5 years of experience in revenue cycle management or related

Skills:

• In-depth understanding of revenue cycle, including patient access, billing, coding, claims processing, and collections
• Familiarity with managing multiple clinical revenue workflows in a complex environment
• Excellent leadership, organizational, and communication skills.
• Analytical mindset with the ability to develop and implement data-driven performance improvements.
• Excellent verbal and written communication skills.
• Strong knowledge of Electronic Data Interchange (EDI) processes and systems.
• Familiarity with payer regulations, reimbursement methodologies, and compliance standards (e.g., HIPAA, CMS).
• Strong project management skills, including planning, execution, and evaluation
• Ability to evaluate and optimize revenue cycle processes to improve efficiency, accuracy, and financial outcomes
• Ability to maintain confidentiality and handle sensitive patient and financial information responsibly
• Ability to adapt to regulatory changes and new technologies in a dynamic healthcare environment

Working Conditions:

• Prolonged periods of sitting and working at a computer
• Standard office environment

Certifications:

None