City/State:
Bronx, New York
Grant Funded:
Yes
Department:
DOSA - Finance
Work Shift:
Day
Work Days:
MON-FRI
Scheduled Hours:
9 AM-5 PM
Scheduled Daily Hours:
7.5 HOURS
Pay Range:
$112,000.00-$140,000.00
Position Summary
The Revenue Cycle Manager is responsible for overseeing all facility revenue cycle operations for multiple Article 32 Behavioral Health Clinics at Montefiore. This role ensures accurate billing, collections, regulatory compliance, and optimal financial performance across addiction outpatient substance abuse, chemical dependency, psychiatry and psychology services. The manager partners closely with clinical leadership, finance, and operations to drive revenue integrity, reduce denials, and improve cash collections.
Key Responsibilities
Revenue Cycle Operations
- Oversee end-to-end revenue cycle functions, including charge capture, coding, billing, claims submission, payment posting, and A/R follow-up
- Ensure timely and accurate submission all facility claims
- Monitor key performance metrics (charges, collections, denial rates, lag days) and implement improvement initiatives
- Manage error logs, work queues and staff assignments to ensure efficient workflows and coverage
Billing Compliance & Regulatory Oversight
- Ensure compliance with Article 32, OASAS, Medicaid, Medicare, Essential and commercial payer requirements
- Oversee billing documentation and coding accuracy for addiction, psychiatric and psychological services (E/M, psychotherapy, modifiers and add-on codes)
- Maintain audit readiness and respond to internal and external audits
- Develop and maintain billing and documentation policies aligned with regulatory guidance
Denials Management & Revenue Optimization
- Analyze denial trends and implement corrective action plans
- Partner with billing vendor, coding, front-end, and clinical teams to address root causes (e.g., authorization, eligibility, documentation gaps)
- Drive improvements in clean claim rate and overall reimbursement performance
- Identify opportunities to optimize payer mix, coding utilization, and visit capture
- Attend various payor meetings to address systematic denial challenges
Team Leadership & Staff Development
- Manage revenue cycle staff, including hiring, training, and performance oversight
- Provide ongoing education to staff, administration and providers on billing rules and workflow updates
- Establish productivity benchmarks and monitor team performance
Provider & Operational Support
- Collaborate with clinic leadership and administration to improve timeliness of all providers in closing services
- Support onboarding of new providers, programs, and service lines (billing setup and workflows)
- Partner with front-end teams and clinical managers to ensure accurate registration, insurance verification, and authorization processes if required by the individual plan
Reporting & Financial Analysis
- Prepare and present revenue cycle dashboards and KPIs to leadership
- Conduct variance analyses (volume, rate, payer mix) to identify performance drivers
- Support budgeting and forecasting processes
Qualifications
Education & Experience
- Bachelor’s degree required (Healthcare Administration, Finance, or related field preferred)
- 5+ years of revenue cycle experience, including 2–3 years in a supervisory or management role
- Experience in Behavioral Health, Addiction, Psychiatry, or Article 31/32 clinics strongly preferred
Technical Knowledge
- Behavioral health CPT and HCPCS coding (E/M, psychotherapy, testing)
- Medicaid/Medicare/Essential/Commercial billing rules, including NYS Medicaid
- Article 32 regulatory requirements
- Epic, IMA, SMARTCloud or similar EMR/billing systems
Skills
- Strong analytical and problem-solving capabilities
- Ability to translate data into actionable insights
- Effective communication and stakeholder management
- High attention to detail with a focus on compliance and accuracy
Preferred Qualifications
- CPC, CPB, or similar certification
- Experience managing hospital billing (HB)
- Experience in an academic medical center or large health system
VK-LI
Montefiore Medical Center is an equal employment opportunity employer. Montefiore Medical Center will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.