General Summary
The Manager of Revenue Cycle Compliance leads the development, implementation, and oversight of compliance activities related to revenue cycle operations. This role ensures adherence to federal, state, and local regulations—including CMS guidelines—and supports risk mitigation through auditing, education, and policy development. The manager collaborates across departments to promote a culture of compliance and operational integrity.
Essential Responsibilities
Responsibilities listed in this section are core to the position. Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position.
Oversee audits, investigations, and complaint resolution related to revenue cycle compliance.
Monitor regulatory changes and ensure adherence to CMS and other federal/state healthcare requirements.
Develop and deliver education, tools, and policies to support compliance across coding, billing, and documentation practices.
Identify and mitigate compliance risks through annual work plans, corrective actions, and audit contributions.
Collaborate with leadership, legal counsel, and regulatory agencies to support monitoring, remediation, and operational alignment.
Analyze data and translate regulatory requirements into practical, compliant workflows and system improvements.
Lead or support projects that enhance revenue cycle compliance infrastructure and reduce organizational risk.
Provide leadership and oversight for team members through performance management, coaching, and professional development to ensure alignment with organizational goals and regulatory standards.
General Responsibilities
Performs other duties as assigned.
Education Requirements
Bachelor’s Degree required.
Experience Requirements
3 to 5 years of progressive leadership experience required, with experience, in an inpatient or outpatient clinic.
License/Certification/Registration Requirements
None required
Knowledge/Skills/Abilities
Deep understanding of healthcare revenue cycle processes and regulatory frameworks.
Ability to interpret and apply CMS, HIPAA, and other compliance standards.
Strong analytical skills for audit review, data tracking, and risk identification.
Effective communication and presentation skills for education and policy dissemination.
Ability to lead cross-functional teams and manage complex projects.
Proficiency in developing policies, procedures, and corrective action plans.
Commitment to ethical standards and continuous improvement.
Ability to collaborate with legal, clinical, and administrative stakeholders.