Position Summary
The Director of Revenue Cycle is responsible for overseeing front-end revenue cycle functions to ensure accurate, timely, and compliant reimbursement for services. This role supervises Revenue Cycle Specialists and leads front-end financial processes including eligibility verification, funding assignment, and authorization management.
In a behavioral health and Centralized Receiving System (CRS) environment, the Director of Revenue Cycle plays a critical role in ensuring proper alignment between clinical services, funding sources (e.g., Medicaid, DCF/Managing Entity, grants), and billing practices. This position works in close collaboration with Operations, Resource Navigators and the Controller to ensure seamless coordination between front-end processes and downstream billing functions, while maintaining a clear separation of responsiblities. This position will also oversee contract/grant billing functions to maximize revenue integrity and compliance.
Key Responsibilities
Revenue Cycle Oversight
Oversee front-end and revenue cycle functions, including:
Eligibility verification
Authorization management
Funding assignment
Ensure services are billed to the correct payer source (Medicaid, insurance, DCF/CFBHN, grants)
Team Leadership & Supervision
Supervise and support Revenue Cycle Specialist and UM Supervisor
Provide training, coaching, and performance management
Establish clear expectations, workflows, and accountability
Foster a culture of accuracy, compliance, and continuous improvement
CRS & Front-End Financial Integrity
Ensure intake and eligibility processes support clean claims and proper funding assignment
Maintain clear separation between clinical decision-making and financial determination
Collaborating with Clinical Leadership and Resource Navigators to align workflows
Compliance & Risk Management
Ensure adherence to:
HIPAA
Medicaid/Medicare regulations
DCF/CFBHN guidelines
Maintain audit readiness and support internal/external audits
Identify and mitigate revenue and compliance risks
Cross-Functional Collaboration
Partner with (healthcare)
Clinical leadership
CRS/Access teams
Resource Navigators
Finance department
Ensure alignment between service delivery, documentation, and reimbursement
Qualifications
Education
Bachelor's degree in Healthcare Administration, Business, Finance, or related field required
Experience
5+ years of experience in healthcare revenue cycle management
Experience in behavioral health, nonprofit, or DCF-funded environments strongly preferred
Prior supervisory experience required
Experience managing outsourced billing vendors preferred
Skills & Competencies
Strong knowledge of:
Medicaid, Medicare, and managed care billing
DCF/Managing Entity funding models
Excellent analytical and problem-solving skills
Strong leadership and team development abilities
Ability to interpret data and drive performance improvements
Effective communication and cross-functional collaboration
Key Performance Indicators (KPIs)
Days in Accounts Receivable (A/R)
Clean Claim Rate
Denial Rate & Resolution Time
Net Collection Rate
Funding Assignment Accuracy
% of Services Successfully Billed
Work Environment
Office-based with collaboration across clinical and administrative teams
May require flexibility to support operational needs
Summary
This role serves as the bridge between clinical operations and financial performance, ensuring that services delivered are accurately funded, compliant, and fully reimbursed.
