Revenue Operations Manager

Position Summary

The Revenue Operations Manager owns the performance, systems, and standards of Minnesota Mental Health’s revenue cycle. This is a working leadership role: the Manager supervises the billing team day to day, is accountable for revenue cycle KPIs, leads the selection and implementation of new systems and workflows, authors and maintains the standard operating procedures the team runs on, and serves as the organization’s internal subject matter expert on behavioral health billing and payer compliance.

The role sits at the intersection of finance, clinical operations, and compliance. Success requires someone who can read a denial trend and diagnose its root cause, then translate that diagnosis into a documented process change, a system configuration, and a coaching conversation with the staff member who owns the step. Behavioral health revenue cycle experience is required — the payer rules, authorization patterns, documentation standards, and confidentiality requirements in this space differ materially from general medical billing.

Essential Duties and Responsibilities

The following reflects the essential functions of the position. Other duties may be assigned as business needs require.

1. Billing Team Leadership and Supervision

•       Provide direct day-to-day supervision of the billing team, including assignment and prioritization of work, workload balancing, and coverage planning.

•       Own the full people-management cycle for the team: interviewing and hiring recommendations, onboarding, training, performance goal setting, ongoing coaching, annual reviews, and corrective action in partnership with Human Resources.

•       Establish individual productivity and quality expectations for each role on the team, monitor performance against them, and address gaps promptly and constructively.

•       Build depth and cross-coverage across billing functions so that no single payer, workflow, or claim type depends on one person.

•       Foster a culture of accuracy, accountability, and continuous improvement; escalate resourcing needs and capacity constraints to leadership with supporting data.

2. Key Performance Indicators and Reporting

•       Own the revenue cycle KPI set end to end: define each metric and its calculation, establish targets, maintain the reporting that produces them, and be accountable for the results.

•       Produce and present a regular revenue cycle performance package to leadership — at minimum monthly — covering trend, variance to target, root-cause analysis of misses, and the specific corrective actions underway.

•       Monitor A/R aging by payer and by service line; drive resolution of aged balances and identify systemic causes of delay rather than working claims one at a time.

•       Analyze denial and rejection data by payer, reason code, provider, and service type; quantify the revenue impact and lead the cross-functional fixes that reduce recurrence.

•       Track and report on charge capture completeness, payer reimbursement against contracted rates, underpayment recovery, and patient collections performance.

•       Build reporting that is self-service and repeatable wherever possible, so performance visibility does not depend on manual assembly.

3. Systems Implementation and Optimization

•       Lead the evaluation, selection, configuration, testing, and rollout of revenue cycle systems and tooling — practice management and billing modules, clearinghouse, eligibility and benefits verification, claim scrubbing and edits, patient payment and statement platforms, and reporting or business intelligence tools.

•       Serve as the business owner and primary administrator for revenue cycle system configuration: fee schedules, payer setup, charge master and code sets, claim edits and scrub rules, work queues, user roles and permissions.

•       Design and implement automation that removes manual, error-prone steps — electronic eligibility checks, ERA and electronic remittance posting, automated claim status, worklist routing, and statement and payment workflows.

•       Manage vendor and clearinghouse relationships: performance expectations, issue escalation, release and upgrade planning, and periodic review of cost against value delivered.

•       Partner with clinical, intake, and IT stakeholders to ensure system changes upstream of billing — scheduling, documentation templates, service coding — do not create downstream revenue leakage.

•       Plan and manage implementations with defined scope, timeline, testing criteria, training plan, go-live support, and post-implementation validation that the change delivered the intended result.

4. Standard Operating Procedures and Process Design

•       Define, document, and maintain written standard operating procedures for every core revenue cycle function: patient registration and insurance verification, prior authorization and reauthorization, charge entry and coding review, claim submission, payment posting, denial management and appeals, patient billing and collections, refunds and credit balances, and month-end close.

•       Establish a documentation standard and revision-control practice so SOPs remain accurate, versioned, dated, and accessible — and are updated when payer rules, systems, or staffing change.

•       Map current-state workflows, identify handoff failures, rework loops, and bottlenecks, and redesign processes to reduce touches per claim and time to payment.

•       Build the SOP set into onboarding and ongoing training so procedures are the operating standard rather than reference material.

•       Define and maintain internal quality assurance and audit routines — including pre-submission claim review and periodic retrospective sampling — with documented findings and follow-up.

5. Compliance and Payer Subject Matter Expertise

•       Serve as the organization’s internal resource for billing, coding, and payer compliance questions from clinical staff, intake, leadership, and the billing team — providing clear, documented, and timely answers.

•       Maintain current working knowledge of the rules governing behavioral health billing and records, including:

◦       Minnesota Health Care Programs (MHCP) and Minnesota Department of Human Services provider requirements, including the Mental Health Uniform Service Standards Act (Minn. Stat. ch. 245I) and applicable MHCP provider manual and bulletin updates.

◦       Commercial payer policies, provider manuals, medical necessity criteria, authorization requirements, and mental health parity obligations under MHPAEA.

◦       HIPAA Privacy, Security, and Breach Notification Rules.

◦       42 CFR Part 2, governing the confidentiality of substance use disorder patient records, as amended by the February 2024 final rule aligning Part 2 more closely with HIPAA (compliance date February 16, 2026).

◦       Federal fraud, waste, and abuse authorities relevant to claims submission, including the False Claims Act and the Anti-Kickback Statute, and exclusion screening obligations.

◦       Current CPT, HCPCS, and ICD-10-CM coding conventions applicable to behavioral health services, including modifier use, place-of-service and telehealth billing rules, and time-based and unit-based service reporting.

•       Translate regulatory and payer changes into concrete operational action — updating SOPs, system configuration, staff training, and internal audit criteria — and communicate the change and its rationale to affected teams.

•       Support and respond to payer audits, records requests, and reviews; assemble documentation, coordinate internal response, and track findings to resolution.

•       Partner with the Compliance and Privacy functions on billing-related policy, risk identification, and remediation; escalate suspected compliance concerns promptly through established channels.

•       Coordinate with credentialing and payer enrollment to ensure provider enrollment, rosters, and effective dates support clean claim submission.

6. Cross-Functional Partnership

•       Work closely with clinical leadership on documentation quality, service coding accuracy, and the operational realities of authorization and medical necessity requirements.

•       Partner with intake and front-office staff on eligibility verification, benefit and cost-share communication, and financial clearance before service.

•       Support finance with revenue forecasting inputs, month-end close, reconciliation, and analysis of payer mix and reimbursement trends.

•       Represent revenue operations in organizational planning — new service lines, new sites, new payer contracts, and system initiatives — identifying billing implications early.

Qualifications

Required

•       Bachelor’s degree in healthcare administration, business, finance, accounting, or a related field — or an equivalent combination of education and directly relevant revenue cycle experience.

•       Minimum five (5) years of progressively responsible healthcare revenue cycle or medical billing experience.

•       Demonstrated behavioral health or mental health billing experience — substantive, hands-on work with behavioral health payer rules, authorization requirements, service coding, and documentation standards. This is a firm requirement for the role.

•       Minimum two (2) years of direct supervisory or team lead experience, including responsibility for performance management.

•       Working knowledge of Medicaid billing — Minnesota Health Care Programs and managed care organization experience strongly preferred — and of commercial payer billing and follow-up.

•       Proven experience implementing or materially reconfiguring a billing, practice management, or EHR revenue cycle system — not solely operating one as an end user.

•       Demonstrated experience writing and maintaining process documentation or standard operating procedures.

•       Applied working knowledge of HIPAA and of confidentiality requirements specific to behavioral health and substance use disorder records.

•       Strong analytical skills with advanced spreadsheet proficiency; ability to build reporting from raw claims and remittance data and to draw defensible conclusions from it.

•       Clear written and verbal communication, including the ability to explain billing and compliance requirements to clinical staff who do not work in revenue cycle.

Preferred

•       Professional certification such as CPC, CPB, CRCR, CHFP, COC, or CPMA.

•       Experience in a Certified Community Behavioral Health Clinic (CCBHC), community mental health center, or multi-site outpatient behavioral health organization.

•       Familiarity with Minn. Stat. ch. 245I service standards and documentation requirements.

•       Experience with value-based, case-rate, grant-funded, or wraparound reimbursement arrangements in addition to fee-for-service.

•       Experience with substance use disorder billing and 42 CFR Part 2 operational requirements.

•       Experience with business intelligence or reporting tools (e.g., Power BI, Tableau) and comfort working directly with data sources.

•       Prior experience building a revenue cycle function or standing up new processes in a growing organization.

•       Familiarity with credentialing and payer enrollment workflows.

Compensation and Benefits

Target base salary: $90,000 annually, commensurate with experience and qualifications. This position is classified as exempt under the executive and administrative exemptions of the Fair Labor Standards Act and applicable Minnesota law.