Revenue Cycle Manager

The Revenue Cycle Manager plays a pivotal role in ensuring the financial sustainability and operational excellence of Haymarket Center, one of Illinois’ leading behavioral health and recovery organizations serving a primarily Medicaid population. This position is responsible for overseeing the end-to-end insurance revenue cycle, including billing, collections, denial management, and reconciliation. The manager will lead both onsite and offsite teams to drive accountability, accuracy, and efficiency in all revenue functions. Success in this role requires a balance of technical expertise, strategic problem-solving, and hands-on leadership to strengthen cash flow, reduce denials, and support the agency’s mission of delivering high-quality care to underserved populations.

ESSENTIAL FUNCTIONS:

Revenue Operations and Oversight

• Direct all daily revenue cycle operations, including claims submission, remittance posting, denial resolution, and collection activities across multiple funding streams (Medicaid, MCOs, SUPR, FQHC, etc.).
• Partner with onsite Client Benefits and Intake teams to ensure accurate benefit verification, eligibility checks, and prior authorization tracking for all payers.
• Oversee performance and quality of offsite billing contractors; define productivity standards, monitor outcomes, and ensure contractual deliverables are met.
• Collaborate with IT, clinical, and quality teams to enhance workflows and strengthen integration between the EHR (NextGen) and billing systems.

Compliance and Quality Assurance

• Ensure all billing practices comply with federal, state, and payer-specific requirements, including Medicaid and MCO regulations.
• Lead internal QA reviews to identify gaps in documentation, coding, and charge capture; coordinate corrective action and staff training.
• Manage payer audits, compliance reviews, and external monitoring activities with accuracy and timeliness.
• Maintain up-to-date IAMHP rosters, NPI, and Medicaid ID listings in collaboration with Quality Assurance and HR.

Data-Driven Performance Management

• Develop and deliver actionable revenue cycle reports (daily, weekly, monthly) for leadership, tracking metrics such as clean claim rate, denial rate, days in A/R, cash collection ratio, and utilization trends.
• Identify and address root causes of denials, payment delays, and revenue leakage; develop strategies to improve key performance indicators.
• Monitor payer performance and proactively engage MCOs and Medicaid agencies to resolve systemic barriers affecting reimbursement.

Leadership and Team Development

• Supervise and mentor the onsite Billing and Eligibility Coordinator and contracted billing teams; provide clear expectations, coaching, and feedback to foster accountability and growth.
• Promote a culture of ownership, accuracy, and continuous improvement within the revenue cycle function.
• Create and maintain comprehensive Standard Operating Procedures (SOPs) to standardize processes and strengthen internal controls.
• Collaborate cross-departmentally to ensure revenue cycle practices align with Haymarket’s broader operational and clinical objectives.
• Drive special projects (e.g., AR cleanup, retro-authorization initiatives, billing automation) to support financial recovery and system readiness.
• Perform other duties as assigned to advance the mission and operational priorities of Haymarket Center.

• Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or a related field required; Master’s degree preferred.
• Minimum 3 years of progressive experience in healthcare revenue cycle operations, including direct experience with Medicaid and MCO billing.
• Minimum 2 years of supervisory or managerial experience, preferably within a behavioral health or FQHC setting.
• Proficiency in electronic health record (EHR) and billing platforms; experience with NextGen or equivalent strongly preferred.
• Advanced Excel and reporting skills (pivot tables, data analytics, variance analysis).
• Proven ability to identify systemic issues, interpret data, and drive measurable improvements.
• Excellent written and verbal communication skills, with the ability to present findings and recommendations to leadership.
• Demonstrated ability to lead teams in a fast-paced, mission-driven environment with professionalism, integrity, and discretion.