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Overview
The successful candidate for this position will become a subject matter expert in all areas relating to revenue cycle management with a specific focus on providing ongoing analysis of the health of the revenue cycle for Yale Medicine and assigned clinical specialties with the goal of improving billings and colletions and resolving coding, billing and payer/contracting issues that may be impacting the revenue cycle.
Required Skills and Abilities
1. Ability to analyze and interpret detailed reports, develop clear conclusions and summarize findings; ability to perform quality assurance on individual accounts, monitor and analyze clinical department and payor key performance indicators and metrics for revenue cycle.
2. Ability to work effectively as a team member; demonstrated team-building skills and ability to develop good working relationships with co-workers and Yale Medicine clinical departments.
3. Ability to work, plan, research, and conduct projects independently with minimal supervision.
4. Ability to organize and prioritize workload to manage multiple tasks and meet deadlines; excellent attendance and reliability.
5. Excellent written and oral communication skills with demonstrated interpersonal ability to facilitate a team based approach.
Preferred Skills and Abilities
Comprehensive knowledge of ICD-10, CPT-4 and HCPCS coding, medical terminology and third party reimbursement policies. Proficiency with MS Word, Excel and PowerPoint. Proficiency with Epic Practice Management System and EMR. CPC certification, work related experience in a private or academic setting.
Principal Responsibilities
1. Regularly reviews billing activity or specific clinical departments or sections. Provides comprehensive, detailed summary of findings (payment history, rejection analysis, frequency and status of unpaid claims, etc.). Communicates and provides regular updates to administration, physicians and coders. 2. Provides advice on operational improvement to enhance efficiency of payment and overall reimbursement of clinical services. 3. Develops, implements, and monitors policies and procedures to optimize provider reimbursement. Functions as a resource and educator for clinical department physicians and all appropriate staff on billing and coding issues by department. 4. Develops training or educational programs and working manuals on procedural guidelines and implementation of new regulatory standards and initiates changes as contracts and regulations change. 5. Collaboratively establishes policies and procedures to resolve issues around claims that are rejected, nor responded to, underpaid, etc. Provides recommendations on how to reduce rejections to improve collections. 6. Researches policies of payers and communicates changes as appropriate. Maintains regular interactions and communication with third party payers. 7. Leads and/or assists with the management and/or performance of ongoing reimbursement projects, including but not limited to in depth analysis of variances and tracking/managing issues with carriers. 8. Performs coding audits, assesses risk and communicates findings. 9. Ensures compliance with University, governmental and all third party regulations, including claim submission, coding accuracy and documentation to support billing. Performs quality assurance processing and assesses degree of risk for non-compliance with internal audit findings. 10. Manages and coordinates decisions on optimizing output of subordinates and colleagues in producing information. 11. May manage staff of both exempt and non-exempt employees. 12. May perform other duties as assigned.
Required Education and Experience
Bachelor’s Degree in Health Care Administration or RN and four years of related work experience or an equivalent combination of education and experience.
Required License(s) or Certification(s)
Required License(s) or Certification(s):
Job Posting Date
04/06/2026
Job Category
Manager
Bargaining Unit
NON
Compensation Grade
Administration & Operations
Compensation Grade Profile
Supervisor; Senior Associate (24)
Salary Range
$68,000.00 - $120,500.00
Time Type
Full time
Duration Type
Staff
Work Model
Remote
Background Check Requirements
All candidates for employment will be subject to pre-employment background screening for this position, which may include motor vehicle, DOT certification, drug testing and credit checks based on the position description and job requirements. All offers are contingent upon the successful completion of the background check. For additional information on the background check requirements and process visit "Learn about background checks" under the Applicant Support Resources section of Careers on the It's Your Yale website.
Health Requirements
Certain positions have associated health requirements based on specific job responsibilities. These may include vaccinations, tests, or examinations, as required by law, regulation, or university policy.
Posting Disclaimer
Salary offers are determined by a candidate’s qualifications, experience, skills, and education in relation to the position requirements, along with the role’s grade profile and current internal and external market conditions.
The intent of this job description is to provide a representative summary of the essential functions that will be required of the position and should not be construed as a declaration of specific duties and responsibilities of the position. Employees will be assigned specific job-related duties through their hiring department.
The University is committed to basing judgments concerning the admission, education, and employment of individuals upon their qualifications and abilities and seeks to attract to its faculty, staff, and student body qualified persons from a broad range of backgrounds and perspectives. In accordance with this policy and as delineated by federal and Connecticut law, Yale does not discriminate in admissions, educational programs, or employment against any individual on account of that individual’s sex, sexual orientation, gender identity or expression, race, color, national or ethnic origin, religion, age, disability, status as a special disabled veteran, veteran of the Vietnam era or other covered veteran.
Inquiries concerning Yale's Policy Against Discrimination and Harassment may be referred to the Office of Institutional Equity and Accessibility (OIEA).
Note
Yale University is a tobacco-free campus.