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The Revenue Cycle Specialist acts as one of the primary liaisons between Revenue Cycle Operations and the assigned service line in all Revenue Cycle matters. This includes, but is not limited to, providing, coordinating, and enabling timely access to accurate patient and financial information in order to provide various functional information in the most effective and meaningful format, as well as analyzing and validating Epic Reports needed for the assigned service line.

Required:

• Three years Revenue Cycle business; Three years reporting and analysis
• Bachelor Degree

Desired:

• EPIC Certification

This position is being handled internally. We are not accepting solicitations from external recruiters or staffing agencies at this time.

Job Details

Description

Why work for us?

• Balboa Nephrology is the largest kidney care practice in California and participates in a national Medicare program focused on value-based care.
• Through our joint venture with Evergreen Nephrology we are a growing organization with opportunities for professional and personal growth.
• We will help you grow in your leadership experiences while learning the new value-based care world.
• Comprehensive benefits package that includes medical, dental & vision on the 1st of the month 30 days after hire.
• Employer contribution of up to 10% of annual pay for your 401K.
• Generous paid time off plus 8 paid holidays!
• Company paid life insurance.
• Join a fast-growing fi eld - employment of medical and health services managers is projected to grow 32 percent from 2020 to 2030, much faster than the average for all occupations.
• Voted 4 years in a row as a Top Workplace of San Diego !

Our Values: Patient-centered I Accountability I Respect I Innovation I Data-Driven

Our Mission: to consistently deliver superior care – Balboa Care – to every patient with kidney disease.

Work Location: Hybrid

• Works out of our Executive Square office in La Jolla, San Diego, CA.
• Eligible for hybrid schedule upon successful completion of onboarding/training. Position is usually in office 2-3days a week, based on business needs.
• Employee must reside within San Diego County, California.

Position Summary:

The Manager of Revenue Cycle reports to the Director of Revenue Cycle Management, and is responsible for planning, coordinating and managing the daily activities of assigned teams including authorizations, claims, payments & credits, medical records, and accounts receivables. The manager works in collaboration to monitor key performance indicators, adjust team priorities, identify risks, and continually improve outcomes.

Pay Range: $80,000 - $90,000/year, with 10% annual bonus

Essential Duties and Responsibilities:

• Oversees day-to-day activities, provides leadership, training, and support while ensuring compliance with policies and procedures.
• Monitors volumes, workqueues, and Key Performance Indicators and adjusts priorities and workflows as necessary to ensure performance metrics are achieved.
• Reviews denials and other issues impacting timely submission and payment and works to improve performance.
• Researches payor policy to ensure proper billing, compliance, and payor/plan setup. Works with EHR vendor to address issues and maintain system.
• Runs reporting, trends, summarizes findings, and implements changes or makes recommendations to improve performance.
• Documents and maintain written standard operating procedures and reference materials.
• Strategizes and implements measures to increase efficiency, reduce costs, and minimize denials and reimbursement delays.
• Demonstrates strong leadership in fostering a collaborative and supportive environment within the team and with other departments both internal and external.
• Supports and actively participates in process improvement initiatives.
• Assists with other duties to support the revenue cycle process and Balboa’s core values.

Required Qualifications:

• High School graduate or equivalent required.
• Five years of current and related experience with oversight of billing and collections operations in a large medical practice, OR a bachelor’s degree in a related area plus 3 years of current and related experience with oversight of billing and collections operations in a large medical practice.
• Thorough and demonstrated knowledge of EPIC EHR in revenue cycle functions.
• Extensive and demonstrated knowledge of Revenue Cycle, Key Performance Indicators and the drivers of high performing revenue cycle teams.
• Experience analyzing trends and adjusting priorities in order to effectively lead to optimal performance and meet Key Performance Indicators.
• Metrics driven with strong analytical skills.
• Ability to effectively supervise and prioritize activities of subordinate staff and to manage complex workflows and multiple priorities involved with billing and/or collections operations.
• Clear communication skills, both oral and written, to be able to effectively manage team and to work with staff, providers, and outside organizations.
• Superb customer service skills.
• Strong proficiency with Microsoft Windows (ability to navigate, create and rename folders, save and organize files), Strong proficiency with Microsoft Office products (Outlook, OneNote, Teams, Excel, Word), proficiency with Adobe PDF. Ability to type 30 words per minute.

Preferred Qualifications:

• 7 Years current experience managing billing and collections for a large medical group practice
• Bachelor’s degree in Business Administration or Healthcare
• Nephrology billing and collections experience
• Six Sigma or other Lean Management certification
• Certification in billing and collections such as HFMA CRCR or CSPPM

Other considerations:

• Background check required
• Travel to other sites located within San Diego County may be required
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
• Supervisory duties – Yes

Language Skills

• While performing duties, the employee is regularly required to talk, hear, read, write, type and respond in English and understand clinical/medical vocabulary written and spoken.

Vision Requirements

Vision requirements include close vision, ability to adjust focus, and see color.

Physical Demands

Physical requirements may vary slightly and should be reviewed with your manager. In general, this position requires the ability to lift up to 35 pounds unassisted; ability to stand for extended periods of time and to perform repetitive stooping, walking, stretching, reaching and some sitting; ability to use full range of body motions required to lift patients, wear a lead apron, and lift and move supplies. Must be able to safely ascend and descend stairs as a core part of the job, with or without reasonable accommodation, when no elevator or lift is present.

Work Environment

Job required tasks routinely involve a potential for mucous membrane or skin contact with blood, body fluids, tissues or potential spills or splashes. Use of appropriate personal protection measures is required for every healthcare provider in these positions. Require to routinely use standard office equipment such as laptop, computer, mouse, and photocopier.

About Balboa United

Beginning in 1973, Balboa has grown from two physicians to a comprehensive nephrology team of 52 board certified physicians and 8 advanced practitioners. On January 1, 2018, Balboa Nephrology Medical Group (BNMG) launched Balboa United, a full-service medical practice management services organization. From one small office, BNMG now has 24 clinical offices throughout San Diego, Imperial, Orange and Riverside counties. In addition to office and hospital-based patient care, Balboa physicians manage the dialysis treatments of approximately 4,500 patients at 88 dialysis centers and conduct Nephrology based clinical research at 6 centers throughout Imperial and San Diego counties (California Institute of Renal Research).

EEO Statement Balboa United is an equal opportunity employer and makes employment decisions on the basis of merit. We want to have the best available person in every job. Our Company policy prohibits unlawful discrimination based on race, color, creed, religion (including religious dress & grooming), sex (including pregnancy, childbirth or related medical conditions), gender (including gender identity and gender expression),marital status, registered domestic partner status, military status, age, national origin or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), genetic information, sexual orientation, or any other basis protected by applicable federal, state, or local law. We also prohibit unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has or is perceived as having any of those characteristics. The Company is committed to compliance with all applicable laws providing equal employment opportunities. This commitment applies to all persons involved in our operations and prohibits unlawful discrimination by any employee of Balboa United, including managers and co-workers. If you believe you have been subjected to any form of unlawful discrimination, submit a written complaint to your manager or Human Resources (HR). Your complaint should be specific and should include the names of the individuals involved and the names of any witnesses. If you need assistance with your complaint, or if you prefer to make a complaint in person, contact the Company's Human Resources Department. We will immediately undertake an effective, thorough, and objective investigation and attempt to resolve the situation.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Revenue Cycle Manager

Location: 6374 N Lincoln Ave, Chicago, IL 60659

Salary: $80,000–$110,000 (DOE)

Reports To: Chief Financial Officer

Department: Finance

Position Summary:

Midwest Refuah Health Center is seeking an experienced and strategic Revenue Cycle Manager to oversee all billing, coding, collections, and reimbursement operations. This role ensures compliance with FQHC regulations and payer requirements while optimizing revenue cycle performance. The manager will supervise a small billing and coding team and collaborate closely with leadership to improve processes and enhance financial sustainability.

Key Responsibilities:

• Lead end-to-end revenue cycle operations including charge capture, claims, denials, collections, and A/R.
• Supervise billing and coding staff, providing training, support, and performance oversight.
• Ensure compliance with Medicare, Medicaid, commercial insurance, and FQHC billing regulations.
• Monitor KPIs such as denial rates and days in A/R; implement improvements to drive efficiency and cash flow.
• Maintain and update fee schedules and the Sliding Fee Discount Program based on federal guidelines.
• Manage escalated billing inquiries and ensure excellent patient communication.
• Coordinate with leadership on audits, financial planning, and cost reporting.
• Provide training to clinical and front desk staff on documentation and billing practices.
• Stay current with payer rules, billing software, and industry best practices.
• Other duties as assigned

Qualifications:

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field.
• Minimum 5 years of revenue cycle experience across medical, dental, and behavioral health services; 2+ years in a supervisory role. Strong knowledge of Medicaid/Medicare billing and FQHC requirements.
• Proficiency in EHR/billing systems (e.g., eClinicalWorks, EPIC, Athena) and coding standards (ICD-10, CPT, HCPCS).
• Excellent analytical, leadership, and communication skills.
• Certifications such as CRCR, CHFP, CRCP, or CPC preferred.

Benefits:

• Medical, dental, and vision insurance
• 401(k) with employer contribution
• Generous PTO and paid holidays
• Life and disability insurance
• Tuition reimbursement and professional development support

Midwest Refuah Health Center is an equal opportunity employer and Federally Qualified Health Center (FQHC). We encourage candidates passionate about our mission of providing accessible, quality healthcare to apply. The Revenue Cycle Manager will be a key contributor to our team, driving financial sustainability while upholding our commitment to patient care.