Revenue Cycle Manager

Revenue Cycle Manager, Advanced Wound Care (Remote)

Location: Remote
Compensation: $75,000 base salary + Bonus Incentive Program

About NIVA Health

NIVA Health is one of the nation’s leading advanced wound care providers, delivering high quality, patient-centered care directly to patients where they are. Since 2015, we have helped thousands of patients achieve improved healing outcomes through innovative, non-invasive, and regenerative care models.

Our mission is to provide a world-class patient and employee experience, and we are committed to building a culture rooted in our core values: Teamwork. Resilience. Open-mindedness. Ownership. Positivity. (TROOP)

Position Overview

Are you ready to build something meaningful and make a measurable impact?

NIVA Health is seeking a strategic, hands-on Revenue Cycle Manager who can do more than oversee billing operations. This leader will build systems, develop people, improve performance, and help create the infrastructure needed to support national growth.

This role is critical to optimizing revenue cycle operations as NIVA Health continues to scale. The ideal candidate brings strong expertise in healthcare billing, Medicare reimbursement, payer processes, and operational leadership, while also aligning with our culture and commitment to excellence.

This is an opportunity for someone who thrives in a fast-paced, growth-oriented environment and wants to play a meaningful role in shaping the future of a nationally expanding healthcare organization.

Key Responsibilities

• Oversee and optimize the full revenue cycle, including charge capture, coding, billing, accounts receivable follow-up, and collections
• Ensure timely and accurate claim submission, with a focus on Medicare and commercial payers
• Monitor and improve key revenue cycle performance metrics, including AR days, denial rates, and net collection rate
• Lead denial management strategy, including root cause analysis, corrective action planning, and process improvement
• Develop, train, and manage internal team members and/or external billing partners
• Build scalable workflows and systems to support rapid organizational growth
• Collaborate cross-functionally with clinical and operations teams to improve alignment, efficiency, and financial outcomes
• Maintain compliance with all federal, state, and payer requirements

Additional Roles and Responsibilities

• Oversee insurance verification and benefits verification processes to ensure accurate coverage determination before services are rendered
• Manage prior authorizations efficiently and accurately to support seamless patient care and optimize reimbursement
• Coordinate and facilitate single case agreements with payers when applicable
• Monitor and manage PCP referrals to ensure all required approvals and supporting documentation are secured
• Partner with clinical, front office, and billing teams to minimize denials, prevent delays, and strengthen overall revenue cycle performance
• Collaborate with Records, Clinical, and Operations teams to ensure timely documentation completion, record accessibility, and claim readiness

Key Performance Indicators (KPIs)

Success in this role will be measured by the ability to improve performance, reduce delays, and build a scalable, high-performing revenue cycle function. Key performance indicators include:

• Clean Claim Rate: 98% or higher
• Claim Submission Timeliness: Claims submitted within 48 hours of encounter or claim-ready documentation
• Denial Rate: 3% or less
• Denial Resolution Turnaround: Average of 5 business days or less
• Claims Paid Without Rework: 95% or higher
• Net Collection Rate: 95% or higher
• AR Days: Quarter-over-quarter reduction and ongoing optimization
• Hold Buckets: Maintained at no more than 25 days behind
• Verification / VOB Accuracy: 98% or higher
• Prior Authorization and PCP Referral Timeliness: 95% or more completed within required timelines
• Documentation Issue Escalation: Identified and communicated within 1 business day
• Monthly Reporting: Delivered accurately and on time
• Revenue Cycle Improvement: Ongoing implementation of workflow improvements that reduce denials, delays, and revenue leakage

What We’re Looking For

• 5+ years of healthcare revenue cycle experience, preferably in wound care, specialty care, or a similarly complex reimbursement environment
• Strong knowledge of Medicare Part B billing, coding, reimbursement, and compliance
• Proven ability to improve revenue cycle performance metrics and operational ou