Full description

Position Summary

The Revenue Cycle Manager is responsible for the strategic oversight and day-to-day management of the hospital’s financial health. This role leads the Billing and Coding teams in a specialized pediatric environment, ensuring high-quality charge capture, accurate coding, and timely reimbursement.

A critical component of this role includes leading the department through a transition from legacy systems (Meditech and Athena) to an Epic platform, while maintaining expert compliance with Illinois Medicaid regulations and pediatric-specific billing requirements.

Key ResponsibilitiesLeadership & Supervision

· Direct Supervision: Manage, mentor, and evaluate the performance of Billing and Coding specialists.

· Staff Development: Provide continuous training on pediatric-specific coding (ICD-10-CM, CPT, HCPCS) and evolving payer regulations.

· Workflow Optimization: Establish departmental KPIs (e.g., Days in AR, Clean Claim Rate, Denial Rate) and hold staff accountable to production standards.

Systems & Implementation

· Legacy Management: Oversee current revenue operations within Meditech (Hospital/Inpatient) and Athena (Ambulatory/Outpatient) to ensure no revenue leakage during the transition.

· Epic Implementation: Serve as the Revenue Cycle Subject Matter Expert (SME) for the Epic go-live. Duties include workflow design, system testing, data migration validation, and end-user training for the billing/coding modules.

· Interoperability: Ensure seamless data flow between legacy archives and the new Epic environment.

Illinois Medicaid & Pediatric Compliance

· Regulatory Expertise: Serve as the primary resource for Illinois Medicaid (HFS) guidelines, including Managed Care Organizations (MCOs) and the All Kids program.

· Pediatric Billing: Manage complex pediatric billing scenarios, including neonatal care, rehabilitative therapy, and long-term pediatric chronic care.

· Audit & Compliance: Conduct internal audits to ensure coding accuracy and compliance with state and federal healthcare laws.

Financial Operations

· Denial Management: Analyze denial trends and implement root-cause solutions to reduce rejections from Illinois Medicaid and commercial payers.

· Reporting: Prepare monthly financial reports and dashboards for senior leadership regarding AR aging and cash collection targets.

· Liaison: Act as the bridge between clinical departments and the finance office to ensure clinical documentation supports billed services

Qualifications· Education: Bachelor’s degree in Healthcare Administration, Finance, or a related field (Master’s preferred).

· Experience: * Minimum 5+ years in Healthcare Revenue Cycle Management.

o Proven experience in a supervisory role overseeing billing and coding professionals.

o Direct experience with Illinois Medicaid reimbursement and policy.

· Technical Skills: * Proficiency in Meditech and AthenaIDX/One.

o Epic Certification or previous experience leading an Epic Implementation (Resolute Hospital Billing/Professional Billing) is highly preferred.

· Certifications: CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or CRCR (Certified Revenue Cycle Representative) preferred

Required Competencies

· Change Management: Ability to lead a team through the technical and emotional challenges of a major EHR transition.

· Analytical Thinking: Deep understanding of healthcare data to identify trends in underpayments or billing errors.

· Pediatric Focus: Sensitivity to the unique billing needs of a small, 39-bed children’s facility.

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.