Qureos Mentor

Stratford Solutions Inc.

<div>Job Title: Revenue Cycle Insurance Manager (Hospital)
Location: Sebring FL
Work Schedule: Normal business hour Monday to Friday
Job Type: Contract to Hire
Salary: $90,000&ndash;$95,000 (+Bonus)
Job Description
Job Title: Revenue Cycle Insurance Manager (Hospital)
Position Summary
The Revenue Cycle Insurance Manager is a senior people leader responsible for driving hospital insurance collections performance through strong leadership, accountability, and payer strategy. This role owns the execution and outcomes of hospital insurance A/R and denials management, leading teams that resolve complex, high-dollar claims while ensuring compliance, consistency, and sustained cash flow. The ideal candidate is a decisive, visible leader who develops talent, enforces standards, and partners across departments to achieve measurable financial results.
Key Responsibilities
Leadership, Culture &amp; Accountability (Primary Emphasis)<ul><li>
Lead, inspire, and develop hospital insurance A/R and denial management teams through clear expectations, coaching, and performance management.</li><li>
Build a high-accountability culture focused on results, quality, compliance, and continuous improvement.</li><li>
Establish clear roles, productivity standards, and quality benchmarks for managers, supervisors, and staff.</li><li>
Conduct regular performance reviews, corrective action, and succession planning for key revenue cycle roles.</li><li>
Serve as a trusted leader and subject matter authority for hospital insurance reimbursement and payer strategy.</li></ul>
Hospital Insurance A/R &amp; Denials Strategy<ul><li>
Own end-to-end performance of hospital insurance accounts receivable, with direct accountability for AR days, aging, and collections.</li><li>
Lead denial prevention, management, and appeals strategy across Medicare, Medicaid, commercial, managed care, and governmental payers.</li><li>
Direct resolution of high-risk, high-dollar, and complex hospital claims requiring escalation or negotiation.</li><li>
Identify payer trends and root causes impacting reimbursement and drive corrective action plans.</li></ul>
Payer Relations &amp; Executive Communication<ul><li>
Serve as the primary escalation point for payer disputes, underpayments, and systemic reimbursement issues.</li><li>
Lead payer strategy discussions and represent the organization in payer meetings and negotiations.</li><li>
Translate operational performance into executive-level insights, risks, and recommendations.</li></ul>
Cross-Functional Leadership &amp; Collaboration<ul><li>
Partner with Coding, CDI, Utilization Review, Case Management, Registration, Compliance, and IT leaders to improve insurance reimbursement outcomes.</li><li>
Lead cross-functional initiatives to reduce preventable denials and improve first-pass resolution.</li><li>
Influence stakeholders without direct authority to drive enterprise-wide revenue cycle improvement.</li></ul>
Financial Performance &amp; Reporting<ul><li>
Establish and monitor hospital insurance revenue cycle KPIs, including AR aging, denial rates, appeal success, and insurance cash.</li><li>
Hold leaders and teams accountable for meeting performance targets through data-driven action plans.</li><li>
Support budgeting, forecasting, and strategic planning related to hospital reimbursement and cash flow.</li></ul>
Compliance, Risk &amp; Audit Oversight<ul><li>
Ensure insurance follow-up and appeals processes comply with CMS, payer contracts, and state and federal regulations.</li><li>
Maintain audit-ready documentation and lead teams through internal and external audits.</li><li>
Proactively identify compliance risks and implement corrective action plans.</li></ul>
Physician Billing Insurance Oversight (Secondary)<ul><li>
Provide leadership oversight for physician/professional insurance A/R to ensure alignment with hospital payer strategies.</li><li>
Monitor denial trends and payer behavior across professional billing to drive consistent enterprise standards.</li></ul>
Qualifications
Required<ul><li>
Bachelor&rsquo;s degree in Healthcare Administration, Business, Finance, or related field (or equivalent experience).</li><li>
7+ years of progressive revenue cycle experience with significant hospital insurance A/R leadership responsibility.</li><li>
Demonstrated success leading teams responsible for hospital collections, denials, and appeals.</li><li>
Strong working knowledge of hospital reimbursement methodologies and payer regulations.</li></ul>
Leadership Competencies<ul><li>
Proven people leader with the ability to motivate, develop, and retain high-performing teams</li><li>
Decisive, accountable, and results-driven leadership style</li><li>
Strong executive presence and communication skills</li><li>
Strategic thinker with the ability to translate data into action</li></ul></div>

Revenue Cycle Insurance Manager (Hospital)

<div>Job Title: Revenue Cycle Insurance Supervisor (Hospital)
Location: Sebring FL
Work Schedule: Normal business hour Monday to Friday
Job Type: Full-Time (Permanent)
Salary: $55,000&ndash;$60,000
Job Description
Position Summary
The Revenue Cycle Insurance Supervisor is a frontline leader responsible for overseeing hospital insurance collections performance through direct team supervision, operational oversight, and payer follow-up strategy execution. This role drives day-to-day accountability for hospital insurance A/R and denials management, ensuring timely resolution of complex claims, adherence to compliance standards, and consistent cash flow performance. The ideal candidate is a hands-on leader who coaches staff, enforces productivity standards, and collaborates cross-functionally to achieve measurable financial outcomes.
Key Responsibilities
Leadership, Team Oversight &amp; Accountability (Primary Emphasis)<ul><li>
Supervise hospital insurance A/R and denial management staff, providing daily direction, coaching, and performance feedback.</li><li>
Establish and monitor productivity, quality, and compliance standards for team members.</li><li>
Conduct regular one-on-one meetings, performance evaluations, and corrective action as needed.</li><li>
Support training, onboarding, and development of insurance follow-up and appeals staff.</li><li>
Serve as a subject matter resource for hospital insurance reimbursement processes and payer guidelines.</li></ul>
Hospital Insurance A/R &amp; Denials Operations<ul><li>
Oversee daily follow-up and resolution of hospital insurance accounts receivable.</li><li>
Monitor AR aging, work queues, and collections activity to ensure timely reimbursement.</li><li>
Supervise denial management and appeals processes across Medicare, Medicaid, commercial, managed care, and governmental payers.</li><li>
Escalate high-dollar, high-risk, or complex claims to senior leadership as appropriate.</li><li>
Identify payer trends and operational gaps impacting reimbursement and recommend corrective actions.</li></ul>
Payer Relations &amp; Issue Resolution<ul><li>
Serve as an escalation point for payer disputes, underpayments, and follow-up issues.</li><li>
Assist leadership in preparing documentation and data for payer discussions.</li><li>
Ensure timely and accurate communication with payers to resolve systemic reimbursement concerns.</li></ul>
Cross-Functional Collaboration<ul><li>
Collaborate with Coding, CDI, Utilization Review, Case Management, Registration, Compliance, and IT teams to reduce preventable denials.</li><li>
Support cross-department initiatives to improve first-pass claim resolution and reduce rework.</li><li>
Communicate operational challenges and trends to leadership with actionable recommendations.</li></ul>
Financial Performance &amp; Reporting<ul><li>
Track and report insurance revenue cycle KPIs, including AR aging, denial rates, appeal outcomes, and cash collections.</li><li>
Hold team members accountable to daily and monthly performance targets.</li><li>
Assist leadership with budgeting input, performance forecasting, and cash flow improvement initiatives</li></ul>
Compliance, Risk &amp; Audit Support<ul><li>
Ensure insurance follow-up and appeals processes align with CMS guidelines, payer contracts, and state/federal regulations.</li><li>
Maintain accurate and audit-ready documentation.</li><li>
Participate in internal and external audits and implement corrective action plans when necessary.</li></ul>
Physician Billing Insurance Oversight (Secondary)<ul><li>
Provide operational support and oversight of physician/professional insurance A/R as directed.</li><li>
Monitor denial patterns within professional billing to ensure alignment with hospital payer processes.</li></ul>
Qualifications
Required<ul><li>
Bachelor&rsquo;s degree in Healthcare Administration, Business, Finance, or related field (or equivalent experience).</li><li>
1&ndash;3+ years of progressive revenue cycle experience with hospital insurance A/R focus.</li><li>
Prior supervisory experience leading insurance follow-up or denial management teams.</li><li>
Strong knowledge of hospital reimbursement methodologies and payer regulations.</li></ul>
Leadership Competencies<ul><li>
Strong team supervision and staff development skills</li><li>
Accountable, organized, and operationally focused leadership style</li><li>
Effective communicator with the ability to escalate issues appropriately</li><li>
Analytical thinker capable of translating performance data into action plans</li></ul></div>

Revenue Cycle Insurance Supervisor (Hospital)

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Revenue Cycle Insurance Manager (Hospital)

Revenue Cycle Insurance Supervisor (Hospital)