The Senior Manager of Radiation Oncology Financial Clearance and Knowledge Management serves as the subject matter expert in Radiation Oncology and leads a team dedicated to maintaining expertise in financial clearance, billing practices/requirements, revenue integrity and regulatory compliance for the Dana-Farber network. This role is centered on optimizing revenue capture and ensuring an efficient financial clearance process within a large and complex academic medical environment, with strict adherence to evolving payer medical policies and billing requirements.
Key responsibilities include overseeing and updating systems for annual CPT code changes, maintaining comprehensive and compliant billing documentation, serving as the primary resource for charge capture and review within the ARIA platform, and working closely with operations staff to ensure timely and accurate billing data is uploaded to the DFCI AR system.
Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS, and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.
Primary Duties and Responsibilities
- Provide comprehensive oversight and strategic direction for the radiation oncology revenue cycle across registration, insurance verification, coding, billing, collections, and denial management. Align plans with organizational goals and financial performance, partnering closely with clinical, administrative, and finance stakeholders. Serve as an integral member of the Clinical Operations Committee to streamline processes and drive enterprise best practices.
- Own charge capture operations and data integrity across ARIA, Epic, and related accounts receivable systems. Lead governance and change management to design, evaluate, and optimize workflows, policies, and long-term system effectiveness. Identify enhancements and training needs, pursue and implement new technologies, and coordinate with external partners and DFCI leadership to plan and execute improvements.
- Serve as the department’s subject matter expert on radiation oncology coding conventions, including modifiers, bundling rules, and payer-specific reimbursement requirements. Establish and maintain documentation standards, policies, and reference materials to ensure consistent, accurate coding. Develop and deliver ongoing education programs for billing and coding staff to maintain compliance with evolving CPT codes, payer policies, and regulations, and support network affiliates with RadOnc billing expertise.
- Oversee analytic support for front-end financial clearance teams, including productivity measurement, workflow effectiveness, and staffing models. Use data to drive short- and long-term improvements in efficiency, quality, and throughput. Direct the complete prior authorization process for radiation oncology procedures to ensure prompt, accurate approvals and minimize delays in patient care.
- Build and lead a robust denials management program, enhancing cross-functional communication and accountability. Develop tools, structure, and root-cause analysis methods to reduce preventable denials and accelerate resolution. Implement best-practice workflows and technology to maximize revenue capture and ensure timely, accurate reimbursement for all services.
- Enforce rigorous adherence to CMS, HIPAA, and payer billing guidelines across all revenue cycle activities. Proactively identify and mitigate compliance risks through internal audits, corrective action plans, and preparedness for external regulatory reviews. Establish policies to prevent fraud, abuse, and improper coding, and oversee transparent patient billing and financial counseling in partnership with Patient Financial Services and clinical teams.
- Supervise a team of high-performing revenue cycle and coding staff. Lead and empower staff in the resolution of intricate billing disputes, denials, and appeals, ensuring thorough root cause analysis and the implementation of sustainable corrective actions. Hire, develop, and manage staff to achieve organizational goals. Set clear expectations, deliver feedback, and monitor performance for quality, efficiency, and compliance with policies and procedures. Mentor staff, foster career growth, and cultivate a positive and productive work environment.
Minimum Job Qualifications:
- Bachelor's Degree Required
- Radiation Oncology Certified Coder (ROCC) required
- Epic certification or Health Care Compliance Association (HCCA) Certification in Healthcare Compliance (CHC) preferred
- 6 years of experience working in revenue cycle operations or related field.
- 5 years of supervisory/management experience.
- 3 years of experience in Radiation Oncology billing operations.
- Experience with Government sponsored commercial insurance as well as hospital and/or physician registration and financial clearance.
- Epic hospital billing (HB) and professional billing (PB) modules experience preferred.
Knowledge, Skills, and Abilities:
At Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong. As relentless as we are in our mission to reduce the burden of cancer for all, we are committed to having faculty and staff who offer multifaceted experiences. Cancer knows no boundaries and when it comes to hiring the most dedicated and compassionate professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.
Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.
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Pay Transparency Statement
The hiring range is based on market pay structures, with individual salaries determined by factors such as business needs, market conditions, internal equity, and based on the candidate’s relevant experience, skills and qualifications.
For union positions, the pay range is determined by the Collective Bargaining Agreement (CBA).
$116,900.00 - $131,300.00
