Job Description

Job Summary:

The Revenue Cycle Performance Manager plays a critical role in ensuring the financial health of KidMed Pediatric Urgent Care by overseeing and optimizing all aspects of the revenue cycle. This includes managing billing operations, improving cash flow, and ensuring compliance with payer and regulatory requirements. With a strong focus on performance metrics, this role drives revenue cycle efficiency and operational excellence across multiple clinic sites.

Key Responsibilities:

• Develop and implement revenue cycle and billing policies to support accurate, timely, and compliant billing.
• Monitor and report on key performance indicators (KPIs) such as claims denial rates, days in A/R, and payment turnaround times.
• Collaborate with clinical, administrative, and finance teams to streamline workflows and improve reimbursement outcomes.
• Ensure compliance with federal and state regulations, payer policies, and coding standards (ICD-10, CPT, HCPCS).
• Oversee and manage third-party billing vendors, ensuring accountability and performance.
• Serve as the subject matter expert on payer relationships, contract compliance, and revenue optimization strategies.
• Conduct regular audits to assess billing accuracy, correct documentation, and revenue leakage risks.
• Provide performance feedback and training to billing staff and clinic teams, even without direct supervisory responsibilities.
• Support leadership in budgeting, forecasting, and revenue analysis.

Qualifications:

• Bachelor’s degree in Healthcare Administration, Finance, Business, or a related field (required).
• Minimum 3 years of hands-on experience in medical billing and revenue cycle operations, preferably in urgent care or outpatient pediatric settings.
• Demonstrated knowledge of payer regulations, credentialing processes, and reimbursement methodologies.
• Strong analytical and problem-solving skills; ability to interpret and act on financial data and trends.
• Experience working with EMR/EHR systems and billing platforms; Excel proficiency required.
• Excellent communication skills with the ability to engage cross-functional teams.
• Highly organized, self-motivated, and performance-driven.

Preferred Experience:

• Familiarity with pediatric and urgent care billing environments.
• Certification in Medical Billing and Coding (e.g., CPC, CPB) is a plus.
• Prior experience managing vendor relationships or remote billing teams.

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