Backend Revenue Cycle Manager
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Job Description
Backend Revenue Cycle Manager leading payer governance, high-dollar denial escalations, and revenue integrity operations. Supervising analysts and coordinating claims inventory across Ascension’s multi-state healthcare system.
Responsibilities:
- Facilitate and document approximately 45 monthly Joint Operating Committee (JOC) executive sessions with key commercial and government payers
- Maintain partnership agreements
- Share policy updates received during JOC meetings with appropriate parties
- Act as the primary escalation lead and senior negotiator for complex, high-dollar claim disputes and denials across five multi-state regions
- Deploy advanced revenue integrity tactics to drive rapid variance resolution and maximum reimbursement
- Direct continuous auditing, triage, and monthly transmission of six specialized escalation logs
- Oversee vendor communication streams, including R1 RCM, to ensure systematic inventory clearance and high-dollar account compliance with Ascension revenue standards
- Direct and develop Senior Analysts
- Establish review standards for claim denial inquiries and escalation documentation criteria
- Manage daily task allocation across competing regional priorities
- Conduct structured monthly reviews on aged inventory discussed at JOC meetings
- Determine whether items should be sent to Legal or R1 RCM for next steps
- Maintain awareness of payer policy updates and contract provisions
Requirements:
- Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA) preferred
- Licensure required relevant to state in which work is performed
- High School diploma equivalency with 3 years of cumulative experience OR Associate's degree/Bachelor's degree with 2 years of cumulative experience OR 7 years of applicable cumulative job specific experience required
- 3 years of leadership or management experience preferred
- Advanced professional revenue cycle certification (e.g., CRCR, CSPR, or CSPPM) preferred
- Direct experience structuring and facilitating JOC or strategic payer-provider alignment frameworks
- Deep subject-matter expertise with major national and regional payer environments, including UHC, BCBS, Cigna, Aetna, and Humana
- Experience with vendor ecosystem integrations, including R1 RCM
Benefits:
- Eligible for an annual bonus incentive
- Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options
- Employer-matched 403(b)
- Planning and hardship resources
- Disability and life insurance
- Pro-rated paid time off (PTO) and holidays
- Ascension-paid tuition (Vocare)
- Tuition reimbursement
- Ongoing professional development and online learning
- Employee Assistance Program
- Counseling and peer support
- Spiritual care and stress management resources
- Parental leave
- Adoption assistance and family benefits
- Optional legal and pet insurance
- Transportation savings
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