Job Description

Position Summary

The Director Revenue Cycle Management is responsible for the overall performance, strategy, and operational management of the organization’s revenue cycle. This role oversees all revenue cycle functions including registration, insurance verification, billing, collections, accounts receivable, credentialing, and patient financial processes. Position will develop and implement strategies to improve cash flow, reduce bad debt, maximize net revenue, and ensure compliance with all regulatory requirements.

The ideal candidate brings strong healthcare financial management experience, a hands-on leadership style, and the ability to standardize and optimize revenue cycle processes across the organization.

Key Responsibilities

Leadership & Strategy

• Serve as a strategic resource to senior management, operations leadership, billing trainers, and revenue cycle staff.
• Develop and manage revenue cycle strategies to meet short-term and long-term organizational goals.
• Establish clear goals, objectives, and performance metrics for revenue cycle operations.
• Develop, implement, and enforce revenue cycle policies, procedures, and guidelines with consistent company-wide application.

Revenue Cycle Operations

• Plan and direct patient registration, insurance verification, billing, collections, and data processing to ensure accurate billing and efficient collections.
• Oversee front office and patient service functions as they relate to revenue cycle performance.
• Set clear productivity expectations and quality standards for reception, patient service representatives, and business office teams.
• Standardize workflows across the revenue cycle to ensure consistency with company standard operating procedures.

Financial Performance & Analytics

• Monitor and evaluate collection effectiveness and ensure insurance billing remains current within established departmental timelines.
• Maximize revenue through accurate charge capture and appropriate charge structures aligned with payer contracts, industry standards, and market conditions.
• Analyze accounts receivable to optimize net revenue, stabilize cash flow, reduce denials, and minimize write-offs.
• Perform audits and develop comprehensive monthly revenue cycle performance reports for leadership.
• Implement recommendations from internal and external audits, consultants, and compliance reviews.

Billing, Coding & Credentialing

• Oversee charge master maintenance, including review and approval of pricing, CPT, HCPCS, and revenue codes.
• Establish and maintain relationships with third-party payers and insurers.
• Manage physician credentialing and re-credentialing processes with private and government payers.
• Ensure compliance with federal, state, and payer-specific regulations.

Process Improvement & Compliance

• Develop and implement process improvements to enhance quality, efficiency, and productivity.
• Ensure consistent communication and enforcement of revenue cycle policies.
• Maintain up-to-date knowledge of healthcare regulations, reimbursement trends, and best practices.

Other

• Perform additional duties as assigned.

Education

• Bachelor’s Degree required or equivalent combination of education and experience.

Experience & Qualifications

• Minimum of three (3) years of experience in healthcare management, including clinic management, patient management, or accounts receivable.
• Strong background in healthcare financial management and revenue cycle operations.
• Knowledgeable of federal and state healthcare laws and regulatory requirements.
• Experience with Athena EMR preferred.
• Proficiency in Microsoft Word, Excel, and PowerPoint.
• Strong leadership, analytical, and communication skills.
• Ability to manage multiple priorities in a fast-paced healthcare environment.

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