DescriptionPosition Overview: The Director, Revenue Recovery serves as the organization's subject matter expert in revenue cycle analytics, revenue recovery strategy, and revenue leakage prevention. This role provides strategic oversight of accounts receivable performance, denial management, claims optimization, and payer reimbursement across institutional and professional billing environments. Partnering closely with clinical, operational, technology, and analytics leaders, the Director identifies systemic barriers to reimbursement, translates complex data into actionable business insights, and drives enterprise-wide initiatives that improve financial performance. The Director is accountable for advancing payer strategy, optimizing revenue recovery processes through automation and AI-enabled solutions, and delivering measurable improvements in clean claim rates, denial reduction, cash flow, and overall reimbursement outcomes.
Essential Responsibilities:
- Manages and develops an effective staff: providing effective communication, leadership, guidance, and resources according to organizational policies and applicable laws and regulations. Determines staff qualifications and competency: recruits, interviews, selects, hires, trains, orients, mentors, evaluates, coaches, counsels, disciplines, and rewards. Establishes and monitors staff safety and regulatory compliance.
- Provides strategic direction and executive oversight of revenue recovery operations, including accounts receivable (AR) management, denial prevention, denial resolution, and payer appeals across all lines of business.
- Establishes and owns revenue cycle performance targets for denial rates, AR aging, clean claim rates, and cash collection velocity; monitors results and reports progress to the VP, Revenue Operations and executive leadership.
- Leads the enterprise-wide strategy for AI, robotic process automation (RPA), and intelligent automation adoption within revenue recovery; partners with technology and analytics teams to evaluate, implement, and optimize tools that reduce manual effort and improve first-pass resolution rates.
- Develops enterprise revenue cycle analytics frameworks, dashboards, and predictive reporting tools to proactively identify reimbursement risks, payer trends, and financial opportunities.
- Conducts advanced root cause analysis of denials, underpayments, payer trends, reimbursement variances, and revenue leakage opportunities. Quantifies financial impact and develops corrective action recommendations for operational leaders. Oversees vendor relationships and third-party performance for outsourced revenue recovery services; establishes and monitors KPIs and holds vendors accountable to defined service levels and financial outcomes.
- Leads payer performance analysis and reimbursement trend monitoring, identifying opportunities for contract optimization, escalation strategies, and recovery initiatives.
- Partners with payer relations, clinical leadership, and compliance to translate regulatory changes, payer policy updates, and contract modifications into timely operational adjustments and staff training.
- Leads cross-functional process improvement initiatives targeting revenue leakage points across the billing cycle; collaborates with eligibility, payment posting, coding, and clinical operations to close gaps at the source.
- Develops and maintains executive-ready dashboards, reporting cadences, and performance narratives that communicate revenue recovery trends, risks, and opportunities to senior leadership.
- Ensures full compliance with federal, state, and payer-specific billing and appeals requirements; maintains current expertise in Medicare, Medicare Advantage, Medicaid, and commercial payer regulations.
Other Duties:
- Performs other related duties as assigned by management.
Supervisory or Managerial Responsibility:
- Directly supervises up to 10 employees and provides strategic direction across revenue cycle functions through influence and cross-functional partnerships.
Minimum Qualifications:
- Bachelor's degree in Healthcare Administration, Finance, Operations, or related field required. Master's degree preferred.
- Minimum of 7 years of experience in revenue cycle management required, with at least 3 years in a leadership role overseeing denial management, accounts receivable, or revenue recovery functions. Multi-payer environment experience required.
- In-depth knowledge of Medicare, Medicare Advantage, Medicaid, and commercial payer regulations required.
- Experience with AI-enabled tools, robotic process automation (RPA), and revenue cycle analytics platforms required.
- Proficiency in Electronic Health Record (EHR) and billing systems including clearinghouses and claims management platforms required. Advanced Microsoft Excel and data reporting tools preferred.
Location: Hybrid Remote and Corporate Office - 9360 Station St, Ste 400, Lone Tree, CO 80124
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