Revenue Cycle Manager
Tutera Senior Living & Health Care
Are you a Revenue Cycle Professional seeking an exciting new career opportunity? Look no further! Tutera Senior Living & Health Care is seeking rockstars to join our team! If you are dedicated and compassionate, WE WANT YOU!
What Will You Do in This Role?
The Revenue Cycle Manager is responsible for the day-to-day leadership and operational oversight of the Central Billing Office supporting a multi-state portfolio of Skilled Nursing Facilities and Senior Living Medicaid Waiver communities.
This position requires expert-level knowledge of Skilled Nursing Facility claims and reimbursement. The Revenue Cycle Manager must be able to independently review and troubleshoot complex SNF claims, understand how information from facility operations and PointClickCare (PCC) ultimately impacts the claim, identify billing and reimbursement errors, interpret payer and contract requirements, and provide expert guidance to billing and denial resolution staff.
The Revenue Cycle Manager oversees a remote Central Billing Office team of approximately 25 employees, including billers, team leads, and denial resolution staff. The team currently supports 45+ Skilled Nursing Facilities and 5 Senior Living Medicaid Waiver communities, with the expectation that the portfolio may increase rapidly.
In addition to managing daily billing operations, this position serves as a primary Revenue Cycle resource for complex payer and claim issues, denial escalation, Triple Check accuracy, facility education, revenue and cash trend analysis, and communication of reimbursement risks and cash delays to Revenue Cycle and senior leadership.
The successful candidate must combine deep SNF claims expertise with strong leadership, analytical ability, attention to detail, sound judgment, and the ability to operate effectively in a fast-paced, high-pressure environment.
Do You Have What It Takes?
Central Billing Office Leadership
- Provide day-to-day leadership and operational oversight of a remote Central Billing Office team of approximately 25 employees, including billers, team leads, and denial resolution staff.
- Oversee billing operations for 45+ Skilled Nursing Facilities and 5 Senior Living Medicaid Waiver communities across multiple states.
- Establish and maintain expectations for billing accuracy, timeliness, productivity, account follow-up, documentation, and accountability.
- Ensure claims are billed accurately and timely and that unresolved billing issues are appropriately prioritized and escalated.
- Monitor team workloads, performance, and productivity across a large and changing facility portfolio.
- Partner with team leads to identify performance concerns, knowledge gaps, and training needs.
- Provide coaching, education, and technical support to billing and denial resolution staff.
- Assist with hiring, onboarding, training, and development of Central Billing Office employees.
- Ensure adequate team coverage and appropriate distribution of responsibilities as the organization grows or facility assignments change.
- Create a collaborative environment while maintaining clear accountability for Revenue Cycle expectations and results.
SNF Claims & Billing Expertise
- Serve as a subject-matter expert for Skilled Nursing Facility claims and reimbursement.
- Independently review complex SNF claims and identify errors affecting billing, reimbursement, or payment.
- Maintain expert knowledge of Medicare, Medicaid, Medicare Advantage/Managed Care, Medicaid Managed Care, commercial insurance, and other payer billing requirements applicable to Skilled Nursing Facilities.
- Understand how information throughout the resident and Revenue Cycle process ultimately impacts the claim, including:
- Census and payer information
- Medicare eligibility and benefit periods
- Qualifying Hospital Stay requirements
- Authorizations
- MDS and PDPM/HIPPS information
- Clinical documentation
- Rates and reimbursement methodology
- Therapy and ancillary services
- Coinsurance
- Payer and contract requirements
- Consolidated billing requirements
- Claim adjustments and corrections
- Understand the complete lifecycle of a SNF claim from admission and payer verification through claim creation, submission, adjudication, payment, denial, adjustment, and final resolution.
- Identify upstream errors that may result in incorrect claims, denials, underpayments, delayed reimbursement, or revenue loss.
- Provide technical guidance when billing staff encounter unusual or complex claim situations.
- Maintain knowledge of changing payer and regulatory requirements affecting SNF billing.
Denial Management & Complex Claim Resolution
- Serve as a primary escalation resource for claims that cannot be resolved through normal billing or denial resolution processes.
- Assist denial resolution staff with complex Medicare, Medicaid, Managed Care, and commercial insurance denials.
- Review denied, rejected, underpaid, or delayed claims to determine the underlying cause.
- Ensure the team is identifying root cause rather than simply correcting individual claims.
- Analyze denial trends to identify recurring issues by payer, facility, claim type, or operational process.
- Determine whether recurring issues originate from billing, payer setup, authorization, census, MDS/clinical information, contract configuration, facility processes, payer processing, or another source.
- Work with appropriate internal departments and payer representatives to resolve systemic reimbursement issues.
- Identify opportunities for education or process correction when preventable denials are recurring.
- Monitor high-value or high-risk claim issues through resolution.
Payer & Contract Support
- Maintain a strong working understanding of payer contracts as they relate to billing and reimbursement.
- Interpret reimbursement methodologies, authorization requirements, covered services, exclusions, carve-outs, filing requirements, rates, and other contractual provisions affecting claims.
- Assist the billing team in determining how contract terms should be reflected in claim submission and expected reimbursement.
- Identify discrepancies between contract terms, payer setup, system configuration, claims, and actual reimbursement.
- Assist with payer issues that are delaying or negatively affecting reimbursement.
- Partner with Payer Relations, contracting, credentialing, and other Revenue Cycle functions when issues extend beyond normal billing resolution.
- Escalate significant payer or contractual concerns that may create material cash delays or revenue leakage.
Triple Check & Claim Accuracy
- Participate in and provide leadership support for the Triple Check process.
- Train facility Business Office Managers and other applicable facility staff on Triple Check expectations and claim accuracy.
- Ensure teams understand how information entered throughout the resident stay ultimately affects the final SNF claim.
- Assist facilities with identifying discrepancies prior to claim submission whenever possible.
- Review claim components and supporting information for consistency and accuracy.
- Identify recurring Triple Check findings and determine whether additional facility or CBO education is needed.
- Provide education regarding the financial impact of inaccurate census, payer, authorization, clinical, MDS, rate, or other information.
- Work collaboratively with facility and corporate teams to reduce preventable billing errors before claims are submitted.
Revenue, Cash & Trend Analysis
- Monitor billing, revenue, cash collections, accounts receivable, denial activity, payer performance, and facility trends across the assigned portfolio.
- Identify negative revenue and cash trends early and investigate the underlying cause.
- Determine whether reimbursement delays are related to billing, payer processing, contract issues, facility execution, census or revenue changes, system configuration, authorization, clinical information, or other factors.
- Analyze significant cash shortfalls and provide timely explanations of the underlying cause.
- Identify potential revenue leakage or reimbursement risk and escalate material concerns.
- Distinguish between expected timing differences and true Revenue Cycle performance issues.
- Use data and claim-level analysis to validate conclusions rather than relying solely on anecdotal explanations.
Senior Leadership Communication
- Provide Revenue Cycle leadership with timely updates regarding significant billing, payer, denial, revenue, and cash issues.
- Communicate material cash delays and their causes in real time when issues are identified.
- Clearly explain what is causing a delay, the financial impact when known, actions underway, and any operational assistance needed.
- Translate detailed billing and reimbursement information into concise explanations appropriate for senior and executive leadership.
- Be prepared to answer questions regarding facility, payer, and portfolio-level Revenue Cycle performance.
- Escalate emerging financial risks before they become significant month-end issues.
- Provide accurate, fact-based analysis in high-pressure situations and when rapid decisions are required.
Facility & Regional Revenue Cycle Support
- Work directly with facility Business Office Managers and Administrators regarding billing, claim, payer, cash, and revenue concerns.
- Partner with Regional Directors of Operations and Regional Vice Presidents when facilities demonstrate negative revenue or cash trends.
- Identify facilities requiring additional Revenue Cycle support based on performance and trends.
- Help determine whether performance issues are related to facility execution, CBO processes, payer behavior, contracts, systems, or other factors.
- Provide education and technical assistance to facility teams when operational processes are negatively affecting reimbursement.
- Support facility and regional leadership with clear explanations of Revenue Cycle findings and financial impact.
- Maintain productive relationships with operational leaders while ensuring accountability for processes that affect reimbursement.
Education & Process Improvement
- Identify knowledge gaps within the CBO and facility teams based on claim errors, denials, Triple Check findings, payer issues, and revenue trends.
- Develop and provide targeted education related to SNF billing and reimbursement.
- Assist with onboarding and ongoing education of billers, denial staff, Business Office Managers, and other applicable personnel.
- Identify recurring billing or reimbursement issues that may indicate a larger process or system concern.
- Recommend improvements when existing processes contribute to billing errors, denials, delayed cash, or revenue leakage.
- Help ensure billing practices remain consistent across the organization while accounting for state- and payer-specific requirements.
Required Qualifications
- Expert-level knowledge of Skilled Nursing Facility claims and reimbursement is required.
- Extensive hands-on experience with SNF billing and complex claim resolution.
- Strong knowledge of Medicare SNF billing requirements and reimbursement.
- Strong knowledge of Medicaid, Medicare Advantage/Managed Care, Medicaid Managed Care, commercial insurance, and other third-party payer billing within the SNF environment.
- Demonstrated ability to independently review and troubleshoot complex SNF claims.
- Thorough understanding of how census, payer information, eligibility, authorizations, MDS/PDPM/HIPPS, clinical information, rates, ancillary services, contracts, and other data affect SNF claims.
- Strong knowledge of claim edits, rejections, denials, adjustments, corrections, underpayments, and reimbursement resolution.
- Ability to identify the root cause of claim and reimbursement problems rather than simply correcting individual transactions.
- Working knowledge of payer contracts and the ability to interpret contract provisions affecting billing and reimbursement.
- Experience with Triple Check and SNF claim validation.
- Demonstrated leadership experience within Revenue Cycle, billing, collections, denial management, or a related function.
- Experience managing centralized, remote, and/or multi-facility Revenue Cycle operations.
- Strong analytical and critical-thinking skills.
- Exceptional attention to detail.
- Strong organizational and prioritization skills.
- Ability to manage multiple competing priorities across a large facility portfolio.
- Ability to work effectively and make sound decisions in high-pressure situations.
- Strong written and verbal communication skills.
- Ability to communicate effectively with frontline employees, facility leadership, regional leadership, corporate departments, and senior executives.
- Strong proficiency with Microsoft Excel and Revenue Cycle reporting and analysis
Preferred Qualifications
- Strong experience with PointClickCare (PCC), including an understanding of how information throughout PCC flows into and impacts SNF billing and claims.
- Experience managing a large remote Central Billing Office.
- Experience overseeing billing operations across multiple states.
- Experience leading or supporting denial resolution teams.
- Experience with Medicaid Waiver billing and Senior Living reimbursement.
- Experience working with payer contracting, credentialing, or payer relations teams.
- Experience providing Revenue Cycle education to facility Business Office Managers and Administrators
Core Competencies
SNF Claims Expertise
Possesses advanced technical knowledge of Skilled Nursing Facility claims and reimbursement and can independently troubleshoot complex billing issues.
Leadership
Effectively leads a large remote team, establishes clear expectations, develops employees, and maintains accountability for results.
Analytical Thinking
Uses financial, billing, payer, and claim-level data to identify trends, anomalies, root causes, and emerging risks.
Attention to Detail
Recognizes discrepancies within claims, payer requirements, contracts, system information, and financial results that may affect reimbursement.
Problem Solving
Looks beyond the immediate claim or denial to determine why the issue occurred and what is necessary to prevent recurrence.
Financial Awareness
Understands the relationship between billing operations, accounts receivable, revenue, and cash and prioritizes work based on financial impact.
Communication
Can move comfortably between detailed technical discussions with billing staff and concise financial explanations to senior leadership.
Sense of Urgency
Recognizes when a billing or payer issue represents a significant financial risk and acts quickly to investigate, communicate, and escalate.
Accountability
Maintains high expectations for accuracy, timeliness, follow-through, and performance while working collaboratively with operational partners.
Adaptability
Functions effectively in a rapidly changing environment with changing payer requirements, organizational priorities, facility acquisitions, and portfolio growth.
Position Scope
The Revenue Cycle Manager currently provides operational leadership for a remote Central Billing Office team of approximately 25 employees supporting:
- 45+ Skilled Nursing Facilities
- 5 Senior Living Medicaid Waiver communities
- Multiple states and payer environments
- Medicare, Medicaid, Managed Care/Medicare Advantage, Medicaid Managed Care, commercial insurance, and other payer types
The facility portfolio and team structure are expected to evolve and may increase significantly based on organizational growth.
The Revenue Cycle Manager operates with a high degree of independence and serves as a critical extension of the Director of Revenue Cycle Management. The position is expected to recognize emerging revenue risks, independently investigate complex reimbursement issues, provide direction to the CBO team, partner effectively with facility and regional leadership, and escalate significant concerns appropriately.
Critical Requirement
This is not an entry-level or general healthcare Revenue Cycle position. Candidates must have extensive hands-on Skilled Nursing Facility claims experience and be capable of independently reviewing, troubleshooting, and resolving complex SNF billing and reimbursement issues.
Why is Tutera THE Employer of Choice?
- Tutera Senior Living & Health Care is guided by one single purpose: To live the YOUNITE philosophy in every decision, every day. Based on genuine respect, YOUNITE is how we get to know residents and team members on a personal level. By asking about our employees’ and residents’ unique needs and preferences, we actively listen and then deliver. Do you want to work for a company where you are the driving force behind every decision made?
- Tutera offers stability; our family-owned company was founded in 1985!
- Tutera offers a competitive starting wage and amazing benefits! We take care of you so you can be a rockstar at work and at home!
- Tutera Senior Living & Health Care is dedicated to growing and developing our Tutera rockstars. Through Tutera University, every employee has the opportunity to learn new skills and become the best they can be!
Apply today and let us show you how we are inspired by you.
Equal Opportunity Employer. The wage and benefit information provided in this listing is subject to change. Benefits eligibility criteria must be met to enroll in available benefits.
