Manager, Revenue Cycle Operations in Green Bay, Wisconsin at Caravel Autism Health

Job Summary

The Revenue Cycle Operations Manager is responsible for the strategic leadership and operational performance of billing, claims management, accounts receivable, denials management, collections, and revenue cycle optimization. This leader drives financial performance through efficient claim submission, denial prevention, AR reduction, reimbursement maximization, and continuous process improvement.

Responsibilities

Billing & Claims Management

• Manage all billing operations, claim generation, claim edits, and claims transmission activities.
• Ensure accurate and timely submission of claims to governmental and commercial payers.
• Establish workflows that reduce billing errors and improve first-pass claim acceptance.
• Oversee coordination with coding, authorizations, and operational teams.
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Accounts Receivable Management

• Lead all AR follow-up and collection activities.
• Monitor aging inventory and implement strategies to reduce outstanding balances.
• Establish productivity and quality standards for AR teams.
• Drive timely resolution of high-dollar and high-risk accounts.
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Denials & Appeals Management

• Develop enterprise denial prevention strategies.
• Monitor denial trends and root causes.
• Oversee appeal submissions and payer dispute resolution.
• Partner with clinical and operational leaders to reduce preventable denials.
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Revenue Cycle Performance

• Establish performance standards and accountability for revenue cycle outcomes.
• Analyze key financial metrics and identify opportunities to improve reimbursement.
• Lead initiatives to improve net collection rates, AR aging, and denial performance.
• Develop dashboards and executive reporting for organizational leadership.
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Regulatory Compliance & Audit Support

• Ensure compliance with payer requirements, billing regulations, and healthcare reimbursement guidelines.
• Support payer audits, record requests, and recoupment disputes.
• Maintain current knowledge of reimbursement and regulatory changes.
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Leadership & Process Improvement

• Lead managers and supervisors responsible for billing, claims, AR, and denial management.
• Implement automation and workflow improvements.
• Establish a culture focused on operational excellence and continuous improvement.
• Partner with Finance, Compliance, Clinical Operations, and Technology teams.

Qualifications

Education:

• Bachelors degree in finance, accounting, business, or a related field required is preferred but not required
• Exposure to healthcare services, behavioral health, or provider-based business models preferred
• Expertise in Revenue Cycle Management Billing, Claims and Receivables in a healthcare services environment

Experience:

• 7+ years of progressive healthcare revenue cycle experience.
• 5+ years of leadership experience managing billing, claims, AR, or revenue cycle teams.
• Comprehensive understanding of healthcare reimbursement methodologies, managed care contracts, denials management, and regulatory requirements.
• Strong analytical and financial management skills.

Skills and Competencies:

• Strong analytical and quantitative skills
• Proficiency in Microsoft Excel and PowerPoint
• Solid understanding of Revenue Cycle Management Billing, Claims and Receivables processes
• High attention to detail and strong organizational skills
• Strong written and verbal communication abilities
• Ability to work effectively in a deadline driven, high intensity environment
• Strong analytical judgment and problem-solving ability
• Team oriented mindset with a professional and client focused approach
• Intellectual curiosity and willingness to learn complex operating models
• High integrity and discretion with confidential information