Manager of Revenue Cycle

La Rabida Children’s Hospital provides specialized, family-centered health care to children with medically complex conditions, disabilities, and chronic illness. Through expertise, compassion, and advocacy we help children and their families reach their fullest potential, regardless of their ability to pay.

Our not-for-profit hospital, licensed for 49 beds, helps transition children from neonatal or pediatric intensive care to home, by providing medical, rehabilitative and developmental care, and by training families to continue treatments and manage the necessary equipment in the home. La Rabida also provides extensive rehabilitation for those recovering from wounds or burns and treatment for exacerbations of chronic conditions.

The hospital’s enhanced pediatric patient-centered medical home provides primary care to children with complex medical conditions and their siblings. Children with medical homes elsewhere come to La Rabida for specialty services. La Rabida offers a wide range of specialty services provided to children with sickle cell disease, diabetes, and many others. Children are supported in their emotional and developmental growth, particularly in cases where such growth has been interrupted by accident or disease.

Finally, La Rabida provides forensic and treatment services for children exposed to abuse and neglect, comprehensive assessments for wards of the state, early intervention for children between 0 and 3 years of age. Care coordination services for medically complex children are also provided for those who are covered by a health plan and receive care from providers in Cook County

Job Description

SUMMARY: Responsible for overseeing revenue cycle operations processes including ongoing chargemaster daily maintenance, billing and collections. Role has direct responsibility for Patient Financial Services. This includes billing, claims submission, denial management and payment posting.

Supervise a small team of revenue cycle staff; recruit, train, coach, conduct performance reviews, and foster professional development.

Monitor KPIs (e.g., days in AR, clean claim rate, denial rate, net collection rate) and generate monthly performance reports.

Analyze and document revenue cycle processes; identify inefficiencies or revenue leakage and implement process improvements.

Responsible for ongoing education and training for clinical providers, and all areas of the Revenue Cycle: Admitting/Registration, Billing, Collections and Coding.

Oversee denial and appeals processes; collaborate with clinical and billing teams to correct frequent errors.

Liaise with payors, clinical departments, and finance to resolve billing issues and ensure accurate charge capture.

Maintain up-to-date knowledge of payer policies, ICD/CPT coding, and federal/state regulations.

Assist with budgeting and forecasting related to revenue cycle.

Ensure compliance with regulatory and contractual requirements, including HIPAA.

Work with EHR/billing system vendors on workflow enhancements

Expectations include working closely with Admitting/Registration, Utilization Review, Business Analytics, Accounting, and Information Systems. As well as maintain external relationships with government payors and Medicaid Managed Care plans. This position will also collaborate with all areas of patient care and serve as the resident expert regarding federal and state billing regulations. This is a hands-on role requiring expertise in Medicaid billing processes and procedures.

Qualifications

QUALIFICATIONS

Education: Undergraduate degree required, Master’s degree preferred.

Related Work Experience: At least five years progressive leadership experience in revenue cycle management; stellar interpersonal skills with the ability to relate to all levels of the organization and external consultants; strong analytical and financial skills, as well as attention to details and effective processes

Licensure/Certification: None

Specialized Knowledge and Skills: Knowledge of federal and state third party payor regulations, especially Illinois; experience with EMR system experience required. Experienced in ongoing education and training for clinical providers, and all areas of the Revenue Cycle.

Additional Information

La Rabida Children’s Hospital is very proud to be an Equal Employment Opportunity Employer

La Rabida is a place unlike any other. We understand the needs of families with children dealing with the most serious or complicated of conditions. With teams of the best healthcare providers in Chicago, we give continuous, comprehensive care, education, and support, helping families face their unique obstacles head-on.

La Rabida Children’s Hospital is very proud to be an Equal Employment Opportunity Employer.