Location: Remote - USA As Revecore's Head of Denials and Receivables, you will: Primarily be responsible for the overall delivery of the Denials & Receivables solutions. Establish and execute operations strategies for solutions beginning with planning and through client delivery. The successful candidate will have the following: Expert-level knowledge of acute care hospital provider revenue cycle operations and systems best practices; expert-level knowledge of denial management strategies and tactics; technical and data savvy; operations savvy and efficiency conscious; excellent communication and collaboration skills; excellent critical thinking skills; experience leading and motivating large teams; deep understanding of the end-to-end RCM and denials business from an RCM vendor perspective; ability to leverage AI-driven tools and technologies to enhance solution delivery
The Role: - Lead delivery of Denials & Receivables solutions, including provide leadership, direction, and guidance to solution delivery team
- Serve as a strategic thought leader in the denials and RCM space, contributing to industry conversations, internal innovation, and competitive positioning
- Develop and execute resource plan to support solution objectives
- Contribute to solution roadmap including technology and resource requirements, including evaluation and adoption of AI and automation capabilities
- Champion a culture of innovation within the team by identifying emerging industry trends, piloting new approaches to denials management, and scaling solutions that deliver measurable outcomes
- Utilizes advanced data analytics to identify trends, track performance, and make data-driven decisions
- Develop and monitor key performance indicators to ensure solution objectives are met. Production Management, Core Metrics, KPIs driven.
- Collaborate with information technology to achieve development objectives
- Identify and implement process improvements to streamline operations
- Develop and execute workforce planning and resource strategies to support solution objectives and organizational scaling
- Ensure adherence to industry regulations and compliance requirements
- Collaborates with other internal departments, such as sales, client success, finance, and human resources to achieve business objectives
- Develop and monitor departmental budgets and forecasts; ownership of solution P&L
- Represent firm in the marketplace to build brand and new business development
- Performs other duties as assigned
You'll be successful if you have: - Minimum 10 years' back-end revenue cycle operations experience with a focus on hospital acute care clients
- Previous executive leadership experience from an RCM vendor environment, both onshore and offshore (i.e. India and Philippines)
- Executive-level communication skills, both written and verbal, with demonstrated ability to present to C-suite and board-level audiences
- Demonstrated experience leveraging AI solutions to improve denials outcomes, workflow efficiency, or predictive analytics. Demonstrated history of bringing innovative solutions or approaches to denials management or broader RCM operations, including process redesign, technology adoption, or new service models
- Technically savvy with the ability to manage large sets of data . You stay current on the technologies that matter in the healthcare revenue cycle space. Strong data analytics abilities, including experience translating complex data sets into actionable operational and strategic insights
- Proven workforce planning capabilities, including forecasting, capacity modeling, and talent strategy in a high-volume operational environment
- Financial acumen - a strong understanding of financial metrics and ability to connect the dots between day-to-day work and business performance
- Demonstrated ability to consistently deliver results. Whether the conditions are ideal or not, you find a way to hit your goals and deliver outcomes that matter to your clients
- Ability and desire to operate at strategic and tactical levels
- Demonstrated computer proficiency including advanced proficiency in Microsoft Excel and working knowledge of MS Office Suite
Work at Home Requirements: - A quiet, distraction-free environment to work from in your home.
- A secure home internet connection with speeds >20 Mbps for downloads and >10 Mbps for uploads is required.
- The workspace area accommodates all workstation equipment and related materials and provides adequate surface area to be productive.
Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check.
Must reside in the United States within one of the states listed below:
Alabama, Arkansas, Florida, Georgia, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts Michigan, Minnesota, Mississippi Missouri, Nebraska, New Hampshire North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, West Virginia and Wisconsin
