Revenue Cycle Manager
Full Time - Non-Union 80000 - 100000 USD per-year-salaryJob Overview
About the Role
Planned Parenthood League of Massachusetts (PPLM) is seeking an experienced Revenue Cycle Manager (RCM) to oversee all aspects of the organization’s revenue cycle operations. This role serves as the primary liaison with PPLM’s revenue cycle partners—including the Clinical Health Network for Transformation (CHN) RCM team and BetterHealth—and plays a key part in ensuring efficient billing, collections, reimbursement processes, and financial sustainability.
The ideal candidate is a strategic thinker with deep knowledge of medical billing, coding, and revenue cycle management, and excels at collaboration, problem-solving, and process improvement.
About the Role
Planned Parenthood League of Massachusetts (PPLM) is seeking an experienced Revenue Cycle Manager (RCM) to oversee all aspects of the organization’s revenue cycle operations. This role serves as the primary liaison with PPLM’s revenue cycle partners—including the Clinical Health Network for Transformation (CHN) RCM team and BetterHealth—and plays a key part in ensuring efficient billing, collections, reimbursement processes, and financial sustainability.
The ideal candidate is a strategic thinker with deep knowledge of medical billing, coding, and revenue cycle management, and excels at collaboration, problem-solving, and process improvement.
Your Day to Day:
- Serve as the primary point of contact between PPLM, CHN Revenue Cycle Team, and BetterHealth.
- Monitor revenue cycle functions and key performance indicators (KPIs), identify best practices, and communicate organizational needs.
- Lead financial analysis and reimbursement planning for new services and strategic initiatives.
- Maintain effective relationships with payer representatives to support contract performance and appropriate reimbursement.
- Report regularly on accounts receivable, KPIs, and trends to the CFO and Health Center leadership.
- Support the accounting team with revenue reporting, reimbursement tracking, and contractual reserve analysis.
- Provide insights and recommendations to improve financial performance and operational efficiency.
- Manage pricing, reimbursement, contract review, and EHR system configuration to optimize workflow and efficiency.
- Partner with health center staff to resolve billing issues and implement improvements.
- Document procedures and create standardized workflows.
- Monitor billing processes for specific programs including AB Funding, At Home STI Testing, and Telehealth Medication Abortion.
- Support compliance activities, including annual coding audits and quarterly audits related to MassHealth certification requirements.
- Stay informed on changes in medical billing standards, regulations, and payer policies.
- Engage regularly with health center teams to review KPIs, identify process barriers, and share best practices.
- Help staff connect operational practices with the organization’s revenue goals and financial sustainability.
- Support organizational productivity initiatives and complete additional tasks as assigned.
Revenue Cycle Oversight & Collaboration
Financial Reporting & Analysis
Process Improvement & Compliance
Cross‑Team Engagement
Qualifications:
- BA/BS degree or equivalent relevant work experience required.
- 8–10 years of experience in revenue cycle operations.
- Experience with Epic, AthenaNet, or comparable EHR systems.
- Proficiency with Microsoft Office 365 (Teams, SharePoint, Excel).
- Advanced knowledge of medical terminology, procedures, and billing practices.
- Strong understanding of HCPCS, CPT, and ICD‑9/ICD‑10 coding standards and collection regulations.
- Knowledge of state and federal billing requirements (including Title X) preferred.
- Strong analytical skills with comfort interpreting financial data.
- Excellent verbal communication, decision-making ability, and organizational skills.
- Commitment to maintaining patient confidentiality in accordance with HIPAA.