Healthcare Revenue Cycle Manager for GI clinic

Job Title: Revenue Cycle Manager

Location: Hilliard, Ohio (Gastro Office & Hilliard Endo Center – separate tax IDs)

Reports To: Office Manager (with close collaboration with COO and CEO)

Direct Reports: 1 Billing Specialist (focused on patient collections, down payments, time-of-service fees, and financial arrangements)

Position Summary

Gastro Office, a growing gastroenterology practice with an attached Quad A-accredited ambulatory surgery center (Hilliard Endo Center), seeks a proactive Revenue Cycle Manager to own end-to-end revenue integrity, coding accuracy, and financial performance. This hands-on leadership role combines deep GI/ASC coding expertise with oversight of outsourced billing, denial reduction, and KPI tracking to drive cash flow and support our Vision.

Core Responsibilities

Coding & Charge Integrity

• Assign and oversee accurate CPT, ICD-10, and HCPCS coding for professional (physician) and facility (ASC) charges, with focus on high-volume GI procedures and compliance with NCCI edits/bundling rules.
• Review and audit medical documentation (procedure notes, op reports, pathology results) for completeness, medical necessity, and specificity identify issues like missing extent of exam (e.g., cecum reached), indication, or findings that trigger denials.
• Conduct charge capture audits and random reviews of endoscopy cases to catch missed revenue (e.g., unreported biopsies, sedation, implants/supplies, add-on codes for dilation/stents).
• Manage coding compliance and quality: Monitor upcoding/downcoding risks, stay current on annual CPT/ICD-10 updates (via AAPC, AGA, ASGE, CMS), implement internal checks, and maintain >95% clean claim rate.
• Research and implement new CPT/HCPCS codes for emerging business lines and link directly to documentation requirements, physician education sessions, and charge master updates to capture new revenue.

Denials & Performance Management

• Perform root-cause analysis on coding-related denials (e.g., incorrect modifier, documentation specificity); categorize all denials, provide targeted physician pointers/education, and track reductions as a Scorecard metric.
• Oversee full revenue cycle KPIs (Days in A/R, denial rate by category including coding, clean claim %, net collection rate, bad debt %) run weekly dashboards, flag trends, and present.

Team & Vendor Oversight

• Supervise and train 1 Billing Specialist on coding-impacting tasks (e.g., how front-end errors affect claims); delegate patient collections/follow-up to them
• Manage relationship with 3rd-party billing company: Conduct weekly check-ins, performance reporting (e.g., coding accuracy audits) and issue escalation
• Collaborate with Office Manager on front-end processes: Quick huddles/shared dashboard reviews for eligibility/authorization issues; ensure reception captures accurate patient info to prevent demographic denials.

Additional Key Responsibilities

• Denial management deep-dive: Full categorization, physician education, and improvement tracking.

Job Type: Full-time

Pay: From $68,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Health insurance
• Paid time off
• Referral program
• Vision insurance

Work Location: In person