Job Description

Imagine Pediatrics is seeking a Manager of Revenue Cycle Operations to lead billing and coding operations, ensure clean claim performance, and drive operational efficiency. This role involves KPI management, strategy support, capitation/value-based care readiness, cross-functional collaboration, team leadership, process improvement, and technology optimization, all while maintaining compliance and audit readiness.

Responsibilities

• Lead billing and coding operations
• Monitor claims workflows and denials
• Ensure provider documentation alignment
• Manage RCM KPIs
• Develop dashboards for revenue forecasting
• Improve performance, quality, and speed
• Ensure coding and reconciliation under capitation
• Support quality measure capture
• Partner with Credentialing and Implementation
• Lead market expansion readiness
• Manage billing and coding staff
• Promote accountability and team culture
• Own RCM SOPs and escalation paths
• Collaborate with Product and IT for system optimization
• Ensure compliance with audit standards

Requirements

• 8+ years of progressive revenue cycle experience
• 5+ years in leadership/strategic operations
• Success building/turning around RCM operations
• Strong payer policy interpretation skills
• Experience with capitated/value-based payment models
• Advanced Athenahealth expertise
• Lean Six Sigma/PMP preferred
• Pediatric/primary care coding knowledge preferred
• Certified Professional Coder (CPC) required
• Proficiency in Excel, Tableau, and claims analytics

Benefits

• No benefits