Revenue Cycle Manager

Revenue Cycle Manager

Primary Purpose:
Under the general supervision of the Director of Patient Financial & Revenue Cycle (DPFRC) The Revenue Cycle Manager is responsible for the overall management and performance of the Clinic and patient revenue cycle, ensuring timely and accurate reimbursement from Medicare, Medi-Cal, commercial insurance, managed care, and private payers. This position oversees all billing office operations from pre-claim review through final payment resolution, including coding, claims submission, accounts receivable, denials management, collections, credentialing, compliance, and reporting.

The Revenue Cycle Manager develops policies, monitors key performance indicators (KPIs), ensures regulatory compliance, improves operational efficiencies, and leads the billing team to maximize
cash collections while maintaining exceptional organization and regulatory compliance.

University of the Pacific recognizes that diversity, equity, and inclusion is foundational to the success of our valued students and employees. We prioritize policy and decision-making that demonstrates awareness of, and responsiveness to, the ways socio-cultural forces related to race,
gender, ability, sexuality, socio-economic status, etc. impede or propel students, faculty, and staff.

Essential Functions:

• Direct and oversee all aspects of the clinic revenue cycle management function, ensuring efficient and compliant billing operations.
• Manage the complete claims lifecycle, including charge entry, claims submission, payment posting, denial management, and account resolution.
• Ensure accurate and timely billing and reimbursement for Medicare, Medi-Cal, commercial insurance, managed care, and self-pay accounts.
• Monitor billing accuracy, clean claim rates, and key revenue cycle performance metrics.
• Develop, implement, and optimize revenue cycle workflows, processes, and improvement initiatives to enhance revenue capture, billing accuracy, collection performance, reimbursement speed, workflow efficiency, automation, customer satisfaction, and overall financial outcomes while reducing claim turnaround times.
• Oversee and ensure timely follow-up on unpaid claims to maximize collections and reduce accounts receivable aging.
• Monitor accounts receivable aging and collection performance.
• Establish collection priorities and productivity goals, analyze reimbursement trends.
• Identify and resolve payment delays through corrective actions, reduce aged receivables, and oversee write-offs and contractual adjustments.
• Develop and implement denial prevention strategies by analyzing denial trends, coordinating appeals, and ensuring timely submission of reconsiderations, corrected claims, and rebilling activities to maximize reimbursement and reduce future claim denials.
• Maintain compliance and documentation with all applicable regulations, including the contracted fee schedules, California Medi-Cal regulations, HIPAA, CMS documentation requirements, and state and federal billing regulations.
• Responsible for monitoring, reporting and improving on the following key performance indicators but not limited to. Net Collection Rate, Gross Collection Rate, Days in Accounts
• Receivable, Aging by Payer, Cash Collections, Charge Lag, Denial Rates, Payment Variances, Bad Debt Trends, and Productivity Metrics.
• Provide recommendations to executive leadership for improvements.
• Supervise and mentor billing office personnel by establishing productivity standards, delivering training and development programs, and fostering a collaborative, accountable, and high-performing team environment.
• Conduct introductory and annual performance reviews.
• Coordinate with billing software vendors, clearinghouses, collection agencies, payment vendors, and insurance representatives and monitor vendor performance.
• Coordinate and oversee internal billing audits, Medicare audits, Medi-Cal audits, ROC audits, and documentation reviews, and implement corrective action plans as needed to ensure regulatory compliance.
• Perform all other duties as assigned by the Director of Patient Financial & Revenue Cycle.

Minimum Qualifications:
Knowledge of:

• Insurance billing, appeals, collections, and contractual adjustments.
• Dental/Medical insurance credentialing
• Demonstrated ability to manage time effectively, balance multiple priorities, and drive tasks and projects to successful completion. Proven track record of navigating complex and urgent issues with clarity and efficiency.
• Dental terminology/treatment and insurance procedures.
• Electronic dental billing systems.
• Accounting/billing procedures.
• Principles of management and supervision.
• Microsoft Excel, Word, and Access.
  
  

Ability to:

• Communicate effectively with a diverse population of patients, students, staff, faculty and administration.
• Produce professional and concise reports and written correspondence.
• Analyze financial reports, and KPI's to make appropriate recommendations.
• Ability to meet benchmarks in a fast-pace high-volume setting
• Work independently with minimal supervision.
• Provide effective leadership, training, and supervision.
• Maintain confidentiality of information.
• Demonstrate professional judgment in all situations.
• Manage multiple projects and consistently meet deadlines.

Experience:

• Minimum of 3-5 years dental insurance claims processing experience.
• Minimum 3 years increasingly responsible management experience, preferably in a dental or medical office.
• Minimum 3 years experience in Revenue Cycle Management.

Education:

• Bachelor's degree in related field or 4 years relevant experience.

Preferred Qualifications:
Ability to:

• Communicate effectively with a diverse population of patients, students, staff, faculty and administration.
• Provide effective leadership, training, and supervision.
• Demonstrate professional judgment in all situations.
  
  

Experience:

• Experience in dental group practice or dental school is highly desirable.
• Bilingual skills helpful.

Other:

• Experience and sensitivity in working with people of diverse backgrounds and cultures.
• Ability to engage and integrate culturally responsive practices and knowledge in their work.

Physical Requirements:
The physical demands described here are representative but not definitive of those that must be met by an employee to successfully perform the essential functions of this job.

• Work performed is primarily office/administrative with frequent use of computer, mouse, and telephone.
• Requires sitting most of the working day; occasionally standing, bending and walking.

Hiring Range: $95,000.00 - $119,000.00 per year. We consider factors such as, but not limited to, scope and responsibilities of the position, candidate's qualifications, internal equity, as well as market and organizational considerations when extending an offer.

Background Check Statement:
All applicants who receive a conditional offer of employment are required to execute a release and authorization for a background screening.

AB 810 Misconduct Disclosure Requirement: University of the Pacific complies with California Assembly Bill 810, requiring candidates accepting conditional job offers to disclose any final administrative or judicial findings, ongoing proceedings, allegations, resignations under investigation, or appeals related to sexual harassment or misconduct within the past seven years.



To apply, visit https://pacific.peopleadmin.com/postings/32986









Copyright ©2025 Jobelephant.com Inc. All rights reserved.

Posted by the FREE value-added recruitment advertising agency

je-11a349e5f99a445c91f745a816f0e749

 

Jobs at The University of the Pacific.

When inquiring or applying for positions at The University of the Pacific, please also reference AcademicCareers.com

Applicants with dual-career considerations can find university jobs such as professor jobs, dean jobs, chair / department head jobs, and other faculty jobs and employment opportunities at The University of the Pacific and at other institutions of higher education in the region on www.AcademicCareers.com

To receive email alerts when new jobs at The University of the Pacific are posted, please sign up at new job openings at The University of the Pacific.