Director – Revenue Cycle

The Director, Revenue Cycle will have the opportunity to build and lead standard processes and a cross-functional team to optimize financial results and improve the patient experience. He or she will partner with coding, clinical, finance, compliance, and operations leadership to align the revenue cycle function with organizational goals around growth, quality, compliance, and member experience. The Director, Revenue Cycle will provide strategic leadership over revenue cycle reporting, denial management, self-pay billing and other related processes through data analysis and establishing scalable processes, policies, and controls. As a member of this team, this individual has exposure to all aspects of the business model and is immersed in the rapidly growing value-based care vertical of the healthcare industry.

Responsibilities

Oversee revenue cycle operations, including insurance verification, partnering with the coding team around charge capture/medical coding, billing/claims submission, payment posting, collections, denial management, self-pay billing, reporting, and patient billing inquiries.

Develop and implement scalable operating procedures and policies, internal controls, and compliance frameworks.

Ensure all revenue cycle operations meet federal/state regulations, payer requirements, coding and documentation standards (ICD-10, CPT, HCPCS, etc.), and privacy/HIPAA compliance; stay abreast of payer requirements and changes in the industry and communicate those changes to team members and leadership.

Define and analyze revenue cycle KPIs (e.g., Days in A/R, denial rates, claim turnaround time, clean claim rate, cash collections, write-offs); monitor and report on KPIs to senior leadership, while identifying opportunities for process improvement.

Lead, mentor, and manage staff across revenue cycle team — including performance management, training, documentation standards, and ongoing education on coding/payer regulations.

Support the client as necessary with any tasks or projects required to deliver excellent personalized care.

Uphold the mission and values of the in all aspects of your role and activities.

Position Requirements

Bachelor’s degree in finance or accounting required

7+ years of experience in claims operations management and revenue cycle

Demonstrated experience managing and scaling a revenue cycle team in a complex healthcare environment (multi-specialty care, value-based or risk-based care models preferred).

Excellent verbal communication skills both in person and over the phone

Analytical skills, financial acumen, and proficiency with revenue cycle management systems / EHR / billing platforms

Working knowledge of ICD-10, HCPCS, and CPT coding

Understanding of Medicare, Medicaid, and third-party billing/coding guidelines and clinical documentation requirements

Highest standards of accuracy and precision; highly organized

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