Director of Revenue

Job Title : Director of Revenue

Business Unit : Administration

Department : Fiscal

Reports to : Chief Financial Officer with ancillary report responsibility to Chief Executive Officer

FLSA : Exempt

Classification : Full-Time (35 Hours)

Grade : 16

Salary Range : $90,000 - $105,000 (Commensurate with experience)

SUMMARY OVERVIEW

The Director of Revenue specializing in medical billing plays a crucial role in maximizing and safeguarding the financial health of Boston Senior Home Care. This individual is responsible for overseeing all aspects of medical billing operations, ensuring accurate, timely reimbursement of services, compliance with policies and regulations, and the maintenance of transparent financial processes. The Director of Revenue acts as a bridge between clinical / operational teams, administrative departments, external payers, and regulatory bodies, striving to optimize revenue cycle management while upholding the organization's mission-driven values.

ESSENTIAL FUNCTIONS

Duties 1-13 are designated as ADA essential functions and must be performed in this job. All other job duties are secondary functions.

• Revenue Cycle Oversight : Manage the end-to-end revenue cycle, including patient registration, charge capture, coding, claim submission, payment posting, denial management, and account reconciliation.
• Medical Billing Management : Supervise the preparation and submission of medical claims to private insurers, government payers (Medicare / Medicaid), and other sources.
• Compliance : Ensure adherence to federal, state, and local regulations, including HIPAA, Medicare / Medicaid guidelines, and nonprofit standards. Maintain up-to-date knowledge of billing requirements and industry changes.
• Team Leadership : Direct, train, and support medical billing specialists and revenue cycle staff. Promote a collaborative, mission-focused work environment.
• Process Improvement : Analyze billing procedures to identify inefficiencies and opportunities for improvement. Implement best practices to enhance accuracy, reduce denials, and accelerate payment cycles.
• Financial Analysis & Reporting : Work with data analyst to provide financial reports related to billing, collections, accounts receivable, and payer mix. Present findings to directors and senior management.
• Denial Management : Investigate and resolve denied or rejected claims, communicating with payers to appeal decisions and secure reimbursement.
• Grant and Contract Revenue : Oversee billing and revenue processes associated with grants and government contracts.
• Payer Relations : Build and maintain effective relationships with insurance representatives, government agencies, and third-party payers to facilitate timely payments and resolve billing issues.
• Patient Financial Services : Ensure that consumer billing is clear, accurate, and compassionate, supporting equitable access to care regardless of financial situation.
• Technology Utilization : Use billing software, electronic health records (EHR), and other digital tools to streamline operations, ensure data integrity, and monitor performance metrics.
• Audit Preparation : Prepare for internal and external audits by maintaining thorough documentation and records.
• Stakeholder Communication : Serve as a resource to clinical operations and executive staff regarding billing questions, procedures, and revenue policies.

COMPETENCIES

PERFORMANCE METRICS

SUPERVISORY RESPONSIBILITY

This position will supervise and train medical billing and revenue cycle staff.

WORK ENVIRONMENT

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

POSITION TYPE / EXPECTED HOURS OF WORK

This is a full-time position, Monday-Friday, 9 a.m. - 5 p.m.

TRAVEL

This position requires up to 25% travel as needed.

REQUIRED / PREFERRED EDUCATION AND EXPERIENCE

ADDITIONAL ELIGIBILITY QUALIFICATIONS

WORK AUTHORIZATION / SECURITY CLEARANCE

AAP / EEO STATEMENT

Equal Employment Opportunity / Affirmative Action / Male / Female / Veteran / Disabled – Boston Senior Home Care affirms and supports diversity and inclusion in our workforce and recognizes all EEOC Factors.

OTHER DUTIES

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Given the nature of the organization and the population it serves, all new employees are required to clear a CORI prior to taking on a new role.

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