The Manager, Revenue Cycle Compliance ensures accurate coding, billing, and reimbursement across hospital and professional services. This role leads audit planning, risk assessments, and compliance education, collaborating with clinical and revenue cycle teams to maintain adherence to federal, state, and payer regulations.
Responsibilities:
Supervises employees, provides direction, coaches, trains and develops, and manages performance to company goals and expectations.
Develop and execute risk-based audit plans.
Conduct pre- and post-payment audits for documentation and billing accuracy.
Coordinate with external auditors and internal departments.
Educate providers on compliance, coding, and billing guidelines.
Investigate complaints and respond to compliance inquiries.
Maintain current knowledge of healthcare regulations and payer requirements.
Communicate audit findings and support corrective actions.
Lead due diligence compliance efforts for mergers, acquisitions, and joint ventures.
Supervise internal and external audit activities and reporting.
Collaborate across departments to improve revenue cycle processes.
Other information:
Technical Expertise
Experience in teaching hospital or pediatric healthcare settings required.
Strong background in physician-based coding and billing.
Familiarity with Medicaid/Medicare regulations.
Skilled in audit procedures, data analytics, and compliance training.
Proficient in Epic, Excel, Word, and healthcare billing systems.
Strong communication and organizational skills.
Education and Experience
Education: Bachelor's degree required.
Certification: CPC or CCS-P required; CPMA preferred.
Years of relevant experience: Minimum 7 years in hospital and professional coding.
Years of supervisory experience: Minimum 2 years in a leadership role.
More Than a Job. It’s loving what you do - and why you do it. Akron Children’s Hospital is ranked among the best pediatric hospitals by U.S. News & World Report, but it’s our compassionate approach to treatment that sets us apart. It’s creating special high-fives. Thinking of new ways to spark a smile. Holding hands to offer comfort. And working to get a giggle that brightens a room. The minute you walk into Akron Children’s, you can sense that people here love what they do. From visits with the Doggie Brigade, to the balloons and smiles in the halls, the sights and sounds are all about one thing: the children. We are the largest pediatric healthcare system in Northern Ohio and one of the fastest growing in the country. Akron Children’s has two hospital campuses in Northeast Ohio: one in Akron and the other in Boardman in the Mahoning Valley. With two hospital campuses, regional health centers and more than 50 primary and specialty care locations throughout Ohio, we’re making it easier for today’s busy families - regardless of where they live - to find the high-quality care they need. No matter which of our locations you choose, you’ll see that when you give the most, you get more—...support, rewards and satisfaction. CAREER OPPORTUNITIES: It’s making the most of your days. Our passion is felt every day in the way people care at every level. Whether you are working with children face-to-face, or behind the scenes supporting the care and services we deliver, you impact futures. Visit us and see why it’s more than just a place to work. It’s a family. Apply today at careers.akronchildrens.org.