Director Of Revenue Cycle

Overview

• Lead revenue cycle management operations for a healthcare organization, ensuring financial accuracy and operational efficiency across departments.
• Collaborate with clinical and administrative teams to optimize workflows and enhance patient satisfaction through streamlined processes.
• Develop and implement strategic initiatives to maximize collections and minimize denials, ensuring robust financial performance.
• Provide mentorship and leadership to revenue cycle teams, fostering professional growth and a collaborative work environment.
• Oversee credentialing and payer enrollment processes with precision and adherence to compliance standards.
• Ensure compliance with federal, state, and industry-specific regulations in all revenue cycle operations.
• Leverage advanced technology solutions to enhance revenue cycle performance and reporting capabilities.
• Prepare and present detailed performance analyses to senior leadership to support informed strategic decision-making.

Key Responsibilities & Duties

• Manage billing, collections, authorizations, and credentialing processes efficiently across multiple healthcare locations.
• Monitor claim submissions, payment postings, and denial management workflows to ensure operational accuracy.
• Ensure timely insurance verification and prior authorization procedures to support seamless patient care.
• Collaborate with technology vendors to optimize electronic medical records and billing systems for enhanced functionality.
• Develop and implement training programs for revenue cycle staff to enhance skills and knowledge.
• Support recruitment, onboarding, and professional development of team members to build a high-performing team.
• Prepare audit reports and compliance documentation for internal and external stakeholders.
• Coordinate payer communications and resolve disputes effectively to maintain positive relationships.

Job Requirements

• Bachelor’s Degree in Healthcare Administration, Business, or a related field; Master’s preferred.
• Certified Professional Coder (CPC) certification or equivalent is preferred.
• Minimum of 2 years of healthcare revenue cycle management experience; 5 years preferred.
• Proficiency in revenue cycle processes, compliance regulations, and payer requirements.
• Experience with Medicare, Medicaid, and commercial insurance systems is essential.
• Strong leadership, communication, and analytical skills to drive team and organizational success.
• Knowledge of surgical or specialty care settings is advantageous.
• Ability to manage onsite teams effectively in a fast-paced healthcare environment.