Revenue Cycle Director
Responsibilities:
• Direct the full revenue cycle function, overseeing eligibility review, prior authorizations, charge capture, billing, payment posting, follow-up, and denial management.
• Lead timely and accurate claim transmission for commercial plans, Medicare, Medicaid, and other government-funded programs to support consistent reimbursement.
• Review aging accounts receivable trends and drive prompt resolution of unpaid or underpaid claims through structured follow-up efforts.
• Research payment variances, claim edits, and denial patterns, then implement corrective actions to reduce revenue leakage.
• Prepare and present recurring reports on billing activity, denials, collections, and other key performance indicators for senior leadership.
• Identify workflow inefficiencies and introduce process enhancements that improve operational effectiveness and strengthen revenue capture.
• Ensure billing practices remain aligned with applicable regulatory requirements and recognized industry standards.
• Work closely with internal teams responsible for billing systems and payer configuration to maintain accurate setup, rate information, and submission integrity.
• Assess accounts for potential adjustments or write-offs and provide recommendations based on financial and operational review.
• Oversee staff performance within the revenue cycle team, including scheduling, timekeeping, and day-to-day team leadership.
Qualifications:
• Proven leadership experience managing healthcare revenue cycle operations across billing, collections, denials, and reimbursement activities.• Strong knowledge of medical billing requirements for commercial insurance, Medicare, Medicaid, managed care organizations, and other payer types.
• Hands-on experience analyzing accounts receivable performance and improving collection outcomes in a healthcare setting.
• Familiarity with regulatory and compliance expectations related to healthcare billing and reimbursement practices.
• Ability to interpret revenue cycle metrics and translate findings into actionable process improvements.
• Background supporting credentialing or re-credentialing activities with government and commercial payers is preferred.
• Experience collaborating with cross-functional teams to maintain billing accuracy, payer setup, and operational alignment.
• Knowledge of healthcare billing environments such as ambulatory surgery or similar provider settings is highly desirable.
Compensation
$47.50-$55.00 HourlyAbout Us
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