Revenue Cycle Systems Manager

Job description

The Revenue Cycle Systems Manager leads and oversees system configuration and maintenance activities within the eClinicalWorks platform that directly impact revenue cycle performance. This role is responsible for payer setup, EDI enrollment and management, file maintenance, fee schedule configuration, and custom reporting. The Supervisor ensures data integrity, system optimization, and alignment between system build and operational workflows to support efficient billing, claims processing, and cash flow. This role partners closely with revenue cycle operations, IT, and payer stakeholders to drive accuracy, scalability, and continuous improvement. Key Responsibilities: Lead the configuration and maintenance of payer records within eCW, including payer setup, updates, and standardization to ensure clean claim submission and accurate adjudication. • Oversee all EDI enrollment activities, including clearinghouse connectivity, payer enrollments (ERA/EFT/EDI), troubleshooting rejections, and maintaining enrollment status tracking. • Manage file maintenance within eCW, including provider master files, facility setup, insurance plans, billing groups, and system tables to ensure data consistency and integrity. • Maintain and update fee schedules within eCW, ensuring alignment with payer contracts, reimbursement methodologies, and organizational pricing strategies. • Design, develop, and maintain custom eCW reports and dashboards to support revenue cycle performance, operational monitoring, and leadership reporting needs. • Partner with AR, billing, and front-end teams to ensure system configurations support workflows for eligibility, charge capture, claim submission, and payment posting. • Troubleshoot system-related issues impacting claims, payments, or reporting; coordinate with internal IT and external vendors to resolve defects and optimize performance. • Establish governance processes for system changes, including documentation, testing protocols, and change control for payer setup, fee schedules, and EDI configurations. • Ensure data accuracy across all revenue cycle system components to minimize claim rejections, denials, and posting discrepancies. • Monitor and improve key system-related KPIs (e.g., clean claim rate, EDI rejection rate, payer configuration accuracy, report reliability). • Develop and maintain standard operating procedures (SOPs) for all system-related functions, including payer build, EDI enrollment, and fee schedule updates. • Ensure HIPAA compliance, data security, and audit readiness across all system configurations and reporting outputs. • Train and support revenue cycle and operational staff on eCW system functionality, reporting tools, and best practices. • Collaborate with payer relations and contracting teams to translate contract terms into accurate system configurations and reimbursement models. • Lead continuous improvement initiatives to enhance system utilization, automate workflows, and improve reporting capabilities. Required Qualifications: • Bachelor’s degree in healthcare administration, information systems, finance, or a related field; or equivalent experience in healthcare revenue cycle systems management. • 5+ years of experience working within eClinicalWorks, with deep expertise in system configuration, payer setup, and revenue cycle workflows. • Strong knowledge of EDI transactions (837, 835), clearinghouse processes, ERA/EFT enrollments, and payer connectivity. • Hands-on experience with fee schedule configuration, payer contract modeling, and reimbursement structures. • Experience building and maintaining custom reports within eCW or equivalent reporting tools. • Strong understanding of end-to-end revenue cycle processes, including front-end, billing, AR, and payment posting workflows. • Proven ability to manage data integrity, system configuration, and process standardization in a complex environment. • Strong analytical, problem-solving, and troubleshooting skills. • Excellent communication and collaboration skills with both technical and operational stakeholders. • High integrity and commitment to HIPAA compliance and data governance. Preferred Qualifications: • Experience in multi-specialty, dermatology, or ophthalmology/refractive services environments. • Experience with clearinghouses (e.g., Change Healthcare, Waystar) and payer enrollment platforms. • Familiarity with SQL, report writing tools, or data visualization platforms. • Experience supporting system implementations, upgrades, or optimizations within eCW. • Certification in healthcare billing, coding, or revenue cycle management (e.g., CPC, CPAR, RCCCERT). Benefits: Excellent Benefits Package (medical, dental, vision,401K) 120 hours of Sick /Vacation time; Paid holidays Access to to support childcare, senior care, pet care, and other family needs. Exclusive discounts on select cosmetic services. Compensation: $66,300 New York City's Largest Dermatology Practice We're a full-service dermatology practice with 50+ locations across Manhattan, Brooklyn, Queens and Long Island. Now Delaware and Philly too!