Revenue Cycle Program Administrator

Schedule

Full-time: 40hrs/wk

Hours: Monday - Friday, Days

General Summary

Leads, implements, and optimizes revenue cycle initiatives across a large healthcare organization. Ensures efficient workflows, regulatory compliance, and financial performance by managing programs related to patient access, billing, collections, denials management, and reimbursement optimization. Collaborates with cross-functional teams, provides data-driven insights, and drives continuous improvement to maximize revenue integrity and operational excellence.

Duties and Responsibilities

Essential Functions:

• Program Management & Process Improvement - Leads and oversees revenue cycle improvement programs to enhance efficiency, reduce denials, and optimize reimbursement. - Develops and implements standard operating procedures (SOPs) for revenue cycle workflows, ensuring alignment with industry best practices. - Monitors and analyzes key performance indicators (KPIs), identifying trends and areas for improvement. - Drives process automation and technology adoption to streamline revenue cycle operations.
• Strategic & Financial Oversight - Collaborates with leadership to develop strategic revenue cycle initiatives that support organizational financial goals. - Assists in budget planning and financial forecasting for revenue cycle programs. - Ensures timely and accurate financial reporting, including cash flow analysis, accounts receivable trends, and revenue leakage prevention. - Develops business cases for technology investments and process enhancements.
• Regulatory Compliance & Risk Mitigation - Stays updated on federal and state healthcare regulations, payer requirements, and compliance standards (e.g., HIPAA, CMS, Medicare/Medicaid). - Implements policies to ensure adherence to regulatory guidelines and mitigate financial risk. - Conducts audits and internal reviews to monitor compliance and identify areas for corrective action.
• Cross-Functional Collaboration & Stakeholder Engagement - Works closely with patient access, coding, billing, collections, and finance teams to align revenue cycle strategies. - Partners with IT teams to optimize revenue cycle management (RCM) systems and ensure data integrity. - Facilitates communication between providers, administrators, and payers to resolve revenue cycle challenges. - Trains and educates internal teams on revenue cycle best practices and process improvements.
• Technology & Data Analytics - Oversees the implementation and optimization of revenue cycle software, including electronic health records (EHRs), billing platforms, and denial management tools. - Utilizes data analytics to measure performance, identify inefficiencies, and drive evidence-based decision-making. - Develops dashboards and reports to track revenue cycle health and performance metrics.

Common Expectations:

• Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.
• Maintains established policies and procedures, objectives, quality assessment and safety standards.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Required for All Jobs:

• Performs other related duties as identified.
• WellSpan Health has adopted and implemented a compliance program to support WellSpan's values and standards for professionalism, integrity, and ethics. Expected to support and meet the values and standards of the organization and the performance expectations of the job, the department, and the compliance program.
• WellSpan Health has adopted and implemented a privacy program to safeguard the patient information and the business and operational information of the organization. Expected to support and meet the values and standards of the organization to safeguard patient and business/operational information.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Physical Demands:

• Standing - Occasionally
• Walking - Occasionally
• Sitting - Frequently
• Reaching - Rarely
• Talking - Frequently
• Hearing - Frequently
• Repetitive Motions - Occasionally
• Eye/Hand/Foot Coordination - Occasionally

Qualifications

Minimum Education:

• Bachelors Degree in Healthcare Administration, Business, Finance, or a related field Required
• Masters Degree Preferred

Work Experience:

• 5 years 5-7 years of progressive experience in revenue cycle management, with at least 3 years in a leadership or program management role Required

Licenses:

• Certified Revenue Cycle Representative Upon Hire Preferred or
• Certified Healthcare Financial Professional Upon Hire Preferred

Knowledge, Skills, and Abilities:

• Proficiency in revenue cycle management systems (e.g., Epic, Cerner, Meditech), financial reporting tools, and Microsoft Office Suite
• Strong understanding of payer contracts, CMS regulations, HIPAA, and revenue cycle compliance
• Strong leadership and program management skills
• Data-driven decision-making and problem-solving abilities
• Excellent communication and stakeholder engagement skills
• Ability to manage multiple projects in a fast-paced healthcare environment
• Detail-oriented with a strategic mindset
• Self-motivated with the ability to work independently in a remote setting