Revenue Cycle Manager

About Central Coast Orthopedic Medical Group

Central Coast Orthopedic Medical Group is a leading orthopedic practice serving the Central Coast. Our skilled physicians and staff deliver exceptional care and advanced treatments in a collaborative and supportive environment that values professionalism and growth.

Position Summary

The Revenue Cycle Manager (RCM) oversees all financial processes related to patient revenue for a busy orthopedic medical group. This role ensures timely and accurate billing, coding, claims processing, reimbursement, and collections. The RCM is responsible for optimizing revenue cycle operations, improving cash flow, ensuring regulatory compliance, and collaborating with clinical and administrative teams to support a seamless patient financial experience.

Key Responsibilities

Revenue Cycle Oversight

• Manage all end-to-end revenue cycle functions, including patient registration, insurance verification, coding, charge entry, billing, payment posting, A/R management, and collections.
• Develop, implement, and monitor processes that improve clean claim rates and reduce denials.
• Analyze financial performance metrics such as days in A/R, denial rates, collection rates, and net revenue recovery.

Coding & Compliance

• Ensure accurate orthopedic coding (ICD-10, CPT, HCPCS) and documentation in alignment with payer policies and regulatory requirements.
• Partner with providers to ensure complete and compliant clinical documentation.
• Oversee internal audits to reduce risk and optimize reimbursement.

Staff Leadership

• Lead, train, and mentor revenue cycle staff, including billing specialists, coders, and front-office team members.
• Set clear performance metrics and conduct regular performance evaluations.
• Create a collaborative environment focused on accuracy, accountability, and continuous improvement.

Payer & Financial Management

• Serve as primary liaison with insurance carriers to resolve complex billing issues and negotiate reimbursement when appropriate.
• Monitor payer policy changes specific to orthopedics (e.g., prior authorizations, surgical bundling, implants).
• Work with leadership to develop financial forecasts, revenue projections, and budget planning.
• Act as a Liason for patients with billing questions

Operational Improvement

• Identify workflow bottlenecks and implement process enhancements using KPIs and data-driven decision-making.
• Lead initiatives to improve patient collections, including transparent billing practices and payment plan programs.
• Ensure the practice’s EHR and practice management systems are optimized for orthopedic workflows.

Regulatory & Policy Compliance

• Maintain compliance with HIPAA, CMS, and commercial payer regulations.
• Ensure adherence to orthopedic-specific billing rules, including global surgical periods and procedure-specific billing guidelines.

Qualifications

Required

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field (or equivalent experience).
• 3–5+ years of revenue cycle management experience in a specialty or multi-specialty medical group.
• Strong knowledge of orthopedic billing and coding guidelines.
• Proven leadership experience.
• Proficiency with EHR and practice management systems (ModMed, Epic, Athenahealth, NextGen, eClinicalWorks, or similar).

Preferred

• Certified Professional Coder (CPC), Certified Professional Biller (CPB), or similar certification.
• Experience with value-based care programs and orthopedic-specific reimbursement models.
• Familiarity with workers’ compensation and personal injury billing processes.

Work Environment

• Office-based with standard business hours, fully on-site
• Occasional travel to clinics
• Join a team that values collaboration, integrity, and excellence in patient care. Apply today to make a meaningful impact at Central Coast Orthopedic Medical Group

Job Type: Full-time

Pay: $80,000.00 - $120,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Experience:

• Revenue Cycle Management: 3 years (Required)

Work Location: In person