Lead and oversee middle- and back-end revenue cycle functions including charge entry, coding, claims submission, payment posting, denial management, patient collections, vendor AR management, and revenue integrity to improve reimbursement and cash flow.
ABOUT: Cardiovascular Services of America (CVAUSA) is the largest private and independent cardiology network in the United States. Our inclusive and diverse network brings together top cardiovascular specialists and thought leaders who offer regional perspectives and a broad strategic vision for the future of patient care.
WHO WE ARE AND WHAT WE DO:
Headquartered in Orlando area, Cardiovascular Associates of America aims to bring the best cardiovascular physicians in one network with the common mission of saving lives, reducing costs, and improving patient care through clinical innovation. Through CVAUSA’s physician-centered practice management model, physicians drive clinical care and their practice culture, while benefiting from the business expertise and shared resources available through CVAUSA for better patient outcomes.
Position Summary
The Manager of Revenue Cycle Operations is responsible for overseeing operational performance across core revenue cycle functions to ensure accurate claim submission, compliant billing practices, timely reimbursement, and optimal financial performance.
This role provides leadership and oversight across middle-cycle and back-end revenue cycle operations including charge entry, coding coordination, claim submission, billing, payment posting, denial management, patient collections, and revenue integrity initiatives. The Manager works collaboratively with clinical, operational, and finance leadership to improve reimbursement outcomes, operational efficiency, revenue capture, and overall financial performance.
Percentage of Time Allocation: 50% Vendor Management / 50% Internal Revenue Cycle Operations
Duties and Responsibilities
Charge Entry & Coding Operations
WHO WE ARE AND WHAT WE DO:
Headquartered in Orlando area, Cardiovascular Associates of America aims to bring the best cardiovascular physicians in one network with the common mission of saving lives, reducing costs, and improving patient care through clinical innovation. Through CVAUSA’s physician-centered practice management model, physicians drive clinical care and their practice culture, while benefiting from the business expertise and shared resources available through CVAUSA for better patient outcomes.
Position Summary
The Manager of Revenue Cycle Operations is responsible for overseeing operational performance across core revenue cycle functions to ensure accurate claim submission, compliant billing practices, timely reimbursement, and optimal financial performance.
This role provides leadership and oversight across middle-cycle and back-end revenue cycle operations including charge entry, coding coordination, claim submission, billing, payment posting, denial management, patient collections, and revenue integrity initiatives. The Manager works collaboratively with clinical, operational, and finance leadership to improve reimbursement outcomes, operational efficiency, revenue capture, and overall financial performance.
Percentage of Time Allocation: 50% Vendor Management / 50% Internal Revenue Cycle Operations
Duties and Responsibilities
Charge Entry & Coding Operations
- Oversee charge capture and professional charge entry processes.
- Ensure coding accuracy and compliance with payer requirements.
- Monitor charge lag and support timely charge entry.
- Oversee claim preparation, claim scrubbing, and submission workflows.
- Ensure claims are submitted timely and accurately according to payer guidelines.
- Monitor claim edits and system workflows to support clean claim submission.
- Oversee ERA and manual payment posting processes.
- Ensure payment reconciliation accuracy.
- Identify and escalate payer payment variances,
Accounts Receivable & Denial Management
- Manage insurance accounts receivable and denial resolution processes.
- Monitor payer trends and implement corrective actions to reduce denials.
- Support timely follow-up on unpaid claims.
- Oversee patient balance collections and refund processes.
- Manage early-out vendors and bad debt placement processes.
- Ensure compliance with refund policies and patient financial regulations.
Revenue Integrity
- Monitor charge capture accuracy and revenue reconciliation.
- Identify revenue leakage and implement operational improvements.
- Support revenue cycle performance monitoring and reporting.
- Serve as the primary point of contact and relationship manager for all outsourced Accounts Receivable vendors and business partners.
- Establish performance expectations, service level agreements (SLAs), and key performance indicators (KPIs) to ensure vendor accountability.
- Conduct regular vendor performance reviews focused on cash collections, aging reduction, denial resolution, productivity, quality, and turnaround times.
- Monitor and analyze AR vendor performance metrics, identifying trends, risks, and opportunities for improvement.
- Partners with vendors to develop and execute action plans to reduce aged AR, improve collection rates, and accelerate cash flow.
- Ensure compliance with organizational policies, payer requirements, contractual obligations, and regulatory standards.
- Facilitate ongoing communication between internal stakeholders and vendors to resolve operational issues and remove barriers to performance.
- Review and approve vendor invoices, evaluate return on investment, and recommend staffing or outsourcing adjustments as needed.
- Provide executive-level reporting and recommendations regarding vendor performance, AR trends, and revenue cycle optimization opportunities.
Performance Accountability / Key Performance Indicators
Staff Performance
Staff Performance
- Staff productivity metrics
- Quality assurance monitoring
- Charge entry accuracy rate
- Charge entry timeliness
- Claim rejection and edit rate
- First-pass claim acceptance rate
- Claim submission timeliness
Revenue Cycle Quality
Qualifications and Skills
Education
- Rework or correction rate
- Denial rate and resolution turnaround time
Qualifications and Skills
Education
- Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or a related field preferred.
- Professional certification such as CPB, CPC, CRC or CHAM is preferred but not required
- Minimum 5 years of experience in healthcare revenue cycle
- Minimum 2 years of leadership or supervisory experience
- Experience working in a physician practice or specialty clinic preferred.
- Experience with AthenaOne, NextGen, eClinicalWorks, or similar practice management systems
- preferred.
- Comprehensive knowledge of healthcare revenue cycle operations including patient access, charge capture, billing, payment posting, accounts receivable, and patient financial services.
- Knowledge of payer reimbursement methodologies including Medicare, Medicaid, and commercial insurance plans.
- Familiarity with CPT, HCPCS, and ICD-10 coding fundamentals and claim submission requirements.
- Understanding of point-of-service collections, patient financial counseling, and insurance benefit structures.
- Ability to lead and develop operational teams across patient access and revenue cycle functions.
- Strong analytical skills with the ability to interpret revenue cycle performance metrics and operational data.
- Experience utilizing healthcare EMR and practice management systems (e.g., AthenaOne, eClinicalWorks, NextGen) and payer portals.
- Knowledge of healthcare compliance requirements including HIPAA, documentation standards, and billing regulations.
- Strong communication, collaboration, and problem-solving skills to support cross-functional operational improvement.
- Benefits: Full benefits package active on day one
- Type: Full-time, Remote position
Similar Jobs
Healthtech
Lead end-to-end revenue cycle operations for multi-state pediatric care, driving clean claim performance, denial management, KPI tracking, capitation readiness, team leadership, process improvement, and EHR/automation optimization to ensure compliance and revenue integrity.
Top Skills:
AthenahealthAutomation ToolsClaim ScrubberClaims Analytics ToolsClearinghouseEhrExcelPayer PortalTableau
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Lead PwC's Energy Incentives practice delivering specialized tax advice on incentives and credits. Oversee large client engagements, drive process improvements, ensure operational excellence, mentor teams, and leverage firm resources to convert market opportunities into client solutions. Engage with senior clients and promote technical thought leadership.
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Lead design and execution of scalable, secure core banking platform architectures. Drive modernization, cloud, API/microservices integration, governance, and risk mitigation. Guide cross-functional teams, engage C-suite clients, run workshops, and support business development for large-scale core banking transformation programs.
Top Skills:
AgileApi-Led IntegrationAWSAzureDevOpsFisInfosys FinacleMicroservicesOracle FlexcubeTemenos T24
What you need to know about the Colorado Tech Scene
With a business-friendly climate and research universities like CU Boulder and Colorado State, Colorado has made a name for itself as a startup ecosystem. The state boasts a skilled workforce and high quality of life thanks to its affordable housing, vibrant cultural scene and unparalleled opportunities for outdoor recreation. Colorado is also home to the National Renewable Energy Laboratory, helping cement its status as a hub for renewable energy innovation.
Key Facts About Colorado Tech
- Number of Tech Workers: 260,000; 8.5% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Lockheed Martin, Century Link, Comcast, BAE Systems, Level 3
- Key Industries: Software, artificial intelligence, aerospace, e-commerce, fintech, healthtech
- Funding Landscape: $4.9 billion in VC funding in 2024 (Pitchbook)
- Notable Investors: Access Venture Partners, Ridgeline Ventures, Techstars, Blackhorn Ventures
- Research Centers and Universities: Colorado School of Mines, University of Colorado Boulder, University of Denver, Colorado State University, Mesa Laboratory, Space Science Institute, National Center for Atmospheric Research, National Renewable Energy Laboratory, Gottlieb Institute
