The Revenue Cycle Director provides strategic oversight and leadership across the full spectrum of revenue operations. This includes designing and driving scalable workflows in authorizations, billing, accounts receivable, and collections to drive sustainable financial performance. By leveraging data-driven insights, the Revenue Cycle Director steers organizational policy, ensures company-wide compliance, and leads a high-performing team to ensure operational goals align with broader corporate financial objectives and regulatory requirements.
Essential Functions:Strategic Revenue Operations & Financial Stewardship- Executive Oversight: Provide strategic leadership for the end-to-end revenue cycle, including authorization procurement, billing, and accounts receivable management.
- Yield Optimization: Implement company-wide strategies to reduce Days in A/R, improve cash flow, and maximize net collection rates.
- Financial Integrity: Ensure the accuracy of payment postings, adjustments, and general ledger reconciliations to maintain high standards of fiscal transparency and audit readiness.
Authorization Governance & Clinical Integration- Continuity Strategy: Design and oversee robust ABA-specific authorization workflows to prevent revenue leakage and ensure uninterrupted patient care.
- Cross-Functional Alignment: Lead collaborative initiatives between clinical, finance, and compliance departments to synchronize operational workflows with payer requirements.
- Patient Financial Experience: Manage the strategy for private-pay invoicing and collections, balancing organizational financial performance with a supportive family-centered experience.
Payer Strategy & Advocacy- Relationship Management: Act as the primary escalation point and negotiator for high-level payer disputes, underpayment trends, and policy changes.
- Regulatory Compliance: Govern the institutional application of CPT codes, modifiers, and payer-specific billing rules to ensure 100% compliance across all service lines.
- Recovery & Revenue Protection: Develop proactive systems to detect and recover underpayments, ensuring the organization receives full contracted value for services rendered.
Advanced Analytics & Performance Intelligence- Data-Driven Leadership: Establish and monitor executive KPIs (e.g., Clean Claim Rate, First-Pass Resolution) to evaluate departmental health and report on organizational performance.
- Business Intelligence: Leverage RCM data and EHR reporting tools to identify macro-trends in payer behavior and lag times, translating complex data into actionable business improvements.
- Denial Management: Direct structured, trend-based denial prevention and appeals workflows to mitigate recurring systemic issues.
Systems Innovation & Organizational Growth- Scalability & Automation: Lead the continuous improvement of the RCM tech stack, leveraging automation and EHR enhancements to support rapid organizational scaling.
- Change Management: Drive the implementation of new payer mandates and system upgrades, overseeing the change management and training required for successful adoption.
- Departmental Development: Mentor and lead the billing and authorization teams, fostering a culture of high performance, accountability, and professional growth.
Qualifications:Education: - High school diploma / GED equivalent required
- Bachelor's degree in business administration, health-related discipline, or equivalent professional experience preferred
Experience:- Minimum of five years of healthcare, hospital, billing, and collection experience in a supervisory capacity.
- Extensive knowledge of technologies, specifically spreadsheet and word processing software and hospital and physician billing software.
- ABA experience preferred.
- Experience with CentralReach preferred.
- Experience with Medicaid billing for primary and secondary reimbursement
- Experience with physician billing
Skills and Competencies:- Strategic focus, with the ability to identify and execute on key business strategies that will support attainment of overall organizational business objectives.
- Ability to effectively lead, coach, manage, mentor and develop others, holding staff accountable as appropriate.
- Strong organizational skills necessary to coordinate and direct the Billing and Authorization functions and related record keeping.
- The analytical skills necessary to review patient accounts for outstanding debts and to apply discounts and administrative write-offs consistently and appropriately, prepare analytical forecasts, etc.
- Effective communication skills needed to interact with other Managers, departmental staff, representatives from regulatory agencies and payers, physicians, and patients (in resolving problems).
- Experience working with basic office machinery and equipment, including computers, copiers, fax machines, multi-line phone systems, etc.
- Demonstrates initiative, with the ability to manage self and others.
- Exemplary customer service focus, with both internal and external clients.
- Able to work both independently and be self-directed, as well as being able to perform in a team atmosphere.
- Displays professionalism and represents organization in a professional manner.
- Ability to abide by ethical guidelines and policies, including strict adherence to confidentiality and HIPPA guidelines.
- Strong knowledge of HIPPA privacy and security rules and regulations.
Remote position--open to candidates in the following locations:
Idaho, Illinois, Iowa, Kansas, Michigan, Minnesota, Missouri, Tennessee, Texas, Wisconsin
