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Director, Revenue Cycle Management

Director, Revenue Cycle Management

New SeasonMAITLAND, FL, US
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Description

Job Summary :

Responsible for overseeing and coordinating revenue cycle activities with a goal of maximizing reimbursement in cost effective manner that is in compliance with federal, state, and payor-specific requirements.

This Director position provides strategic and operational leadership for payment posting and patient financial support services. This role ensures the accuracy, timeliness, and compliance of all cash applications while overseeing financial counseling programs that help patients / customers understand insurance options and manage their financial obligations. The Revenue Cycle Director is also responsible for supervising and developing the Patient Accounts Manager and the Patient Accounts Supervisor.

Although not the current focus of this position the Director must have an in depth known and experience all revenue cycle activities include registration, credentialing, coding, charge capture, charge entry, billing, collecting, payment entry, and reimbursement analysis.

The Director partners across revenue cycle, finance, patient access, and IT to improve operational efficiency, strengthen financial performance, and enhance the overall customer and patient experience.  Finally, this position will be responsible for establishing productivity standards / goals and monitoring performance against these.

Essential Functions :

  • Cash Posting Oversight
  • Direct all cash application activities, including insurance payments, patient payments, adjustments, and refunds.
  • Ensure accurate reconciliation of deposits, ERAs, lockbox, and manual payments with accounting systems.
  • Implement controls to prevent errors, resolve discrepancies, and maintain compliance with payer contracts and financial regulations.
  • Financial Counseling Oversight
  • Lead case management team that provides information on insurance coverage options and financial assistance eligibility (grants).
  • Ensure compliance with federal / state regulations and organizational financial assistance policies.
  • Promote a customer / patient-first approach while meeting organizational financial goals.
  • Performance Management & Process Improvement
  • Develop and monitor KPIs for both cash posting accuracy and financial counseling effectiveness.
  • Use data analytics to identify trends, reduce errors, and improve turnaround time.
  • Drive automation, system enhancements, and workflow efficiencies across both functions.
  • Leadership & Team Development
  • Recruit, train, and develop managers and staff; foster a culture of accountability, integrity, and service excellence.
  • Provide coaching, mentorship, and professional growth opportunities to build leadership capacity within the department.
  • Collaboration & Communication
  • Partner with finance, patient access, clinical leadership, and IT to align revenue cycle functions with broader organizational goals.
  • Represent the department in internal audits, external reviews, and leadership meetings.
  • Serve as a trusted resource to leadership for insights on cash flow, payment accuracy, and patient financial experience.

Expanded Functions :

  • Develops, implements, and maintains CMG revenue cycle standard operating procedures.
  • Ensures patient eligibility is checked and benefits are verified in accordance with payor contracts and as necessary to minimize accounts receivable exposure.
  • Ensures timely and accurate billing of claims to payors.
  • Monitors accounts receivable aging and ensures appropriate collection procedures are being followed.
  • Establishes internal collection goal(s) and regularly compares to identified external benchmark(s).
  • Resolves escalated reimbursement issues with payors.
  • Participate in / project manage special projects as requested / required

    Supervisory Responsibilities :

    Provides leadership and guidance to the Patient Accounts Manager and Patient Accounts Supervisor in the conduct of their job.  Accurately assesses their strengths and development needs and provides timely feedback and coaching.

    Essential Qualifications :

    Education / Certification :                        Bachelor’s degree in business or related field required

    Required Knowledge :                           Proficiency in Microsoft Excel.  Strong knowledge of medical billing, including ICD-10.  Knowledge of behavior health billing

    Experience Required :                           7+ years of progressive revenue cycle, financial operations, or healthcare leadership experience. At least four years medical revenue cycle management experience required.  Experience with behavioral health billing preferred.

    Skill and Ability :

  • Strong knowledge of cash posting processes, reconciliation, health care coverage options through the Marketplace, insurance patient financial services, and regulatory requirements.
  • Demonstrated success in managing multi-site or multi-function teams.
  • Skilled in process improvement, automation, and data-driven decision making
  • Ability to work collaboratively with colleagues.
  • Strong organizational skills with a keen ability to prioritize and multi-task.
  • Ability to adhere to and meet deadlines.
  • Good communicator (oral and written).
  • Strong administrative and data management skills.
  • Ability to raise issues proactively and in a timely manner.
  • Job or State Requirements

    Bachelor's Degree in Business or related field. At least 4 years of medical revenue cycle management required

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    Director Revenue Cycle • MAITLAND, FL, US