Note: The job is a remote job and is open to candidates in USA. Traditions Behavioral Health is hiring a Revenue Operations Manager to own its fee-for-service revenue operations. The role oversees revenue data and reporting, payment reconciliation, physician payment support, and the outsourced billing vendor while developing scalable processes and controls.
Responsibilities
- Design, build, and maintain a centralized database for fee-for-service revenue, including services rendered, claims, payments, adjustments, collections, payer information, physician attribution, and customer or contract data
- Create repeatable data-import, validation, and reconciliation processes using information from internal systems and the outside billing vendor
- Establish and maintain data definitions, reporting methodologies, audit trails, and documentation to support consistent and reliable reporting
- Develop dashboards and recurring reports showing collections, reimbursement trends, aging balances, denials, payment variances, and revenue performance by physician, payer, customer, and contract
- Identify data quality issues and work with internal stakeholders and vendors to resolve incomplete, inconsistent, or inaccurate information
- Own the reconciliation of services rendered, claims submitted, payments received, contractual adjustments, denials, and outstanding balances
- Validate payments against expected reimbursement and investigate underpayments, missing payments, unapplied cash, and other variances
- Ensure revenue and collections are accurately attributed to the appropriate physician, payer, customer, and contract
- Identify revenue leakage, collection delays, and process gaps, and coordinate corrective action
- Provide accurate revenue information to support monthly financial close, forecasting, budgeting, and contract-performance analysis
- Serve as the primary internal contact and relationship manager for the outsourced billing and revenue cycle vendor
- Establish clear deliverables, reporting standards, service expectations, and performance measures for the vendor
- Lead recurring vendor review meetings, track open issues and action items, and escalate unresolved billing, payment, or collection matters
- Review vendor output for timeliness, accuracy, and completeness, and hold the vendor accountable for agreed-upon performance
- Calculate and validate physician payments when compensation is based on fee-for-service revenue or collections
- Prepare clear supporting statements showing the revenue and payment activity used in physician payment calculations
- Communicate with physicians regarding payment calculations and respond to questions about collections, attribution, timing, and adjustments
- Research and resolve discrepancies affecting physician payments in coordination with Finance, Operations, and the billing vendor
- Develop and maintain written procedures, internal controls, reconciliation standards, and reporting calendars for revenue operations
- Partner with Finance, Operations, Contracting, Credentialing, and clinical leadership to address issues affecting billing or collections
- Support audits, payer reviews, financial reporting requests, and other revenue-related analyses
- Recommend and implement process and system improvements that increase accuracy, visibility, scalability, and collection performance
Skills
- Bachelor's degree in Finance, Accounting, Healthcare Administration, Business Analytics, Information Systems, or a related field, or equivalent relevant experience
- Five or more years of experience in healthcare revenue operations, revenue cycle, healthcare finance, payment reconciliation, or data analytics
- Demonstrated experience independently owning a complex reconciliation, reporting, or revenue process
- Proven self-starter who takes ownership, independently investigates unfamiliar issues, identifies the information and resources needed, and develops practical solutions with limited direction
- Experience working with or overseeing an outsourced billing or revenue cycle vendor
- Strong understanding of healthcare fee-for-service claims, reimbursement, collections, adjustments, denials, and accounts receivable
- Advanced Excel skills and demonstrated ability to organize, validate, analyze, and reconcile large datasets
- Experience building or maintaining databases, structured data repositories, dashboards, or reporting systems
- Strong written and verbal communication skills, including the ability to explain payment calculations and variances clearly to physicians and leadership
- High degree of accuracy, discretion, ownership, and follow-through
- Experience in physician practice management, behavioral health, or multisite healthcare services
- Working knowledge of Medicare, Medicaid or Medi-Cal, and commercial payer reimbursement
- Experience with SQL, Power BI, Tableau, relational databases, or similar analytics and business intelligence tools
- Experience developing vendor performance metrics, revenue dashboards, or physician-level collection reporting
Benefits
- Fully remote work
Company Overview
Company H1B Sponsorship