Director of Revenue and Reimbursement

MP RPO; Wolfeboro (NH); Presencial; USD 180 000 - 240 000; Tempo integral

Resumo da oferta

MP RPO seeks a Director of Revenue Cycle to lead back-end operations of a healthcare organization, driving reimbursement accuracy, billing and collections excellence, and financial performance.

Reporting to the CFO, this leader will oversee coding, claims management, cash posting, A/R, denials, and revenue integrity while partnering across clinical and operational teams to optimize reimbursement and ensure compliance.

Qualificações

• 7+ years of healthcare revenue cycle leadership experience.
• Deep knowledge of HCPCS, ICD-10, and reimbursement practices.
• Ability to analyze financial information and drive performance improvements.
• Experience managing teams and third-party vendors.
• Strong communication and problem-solving skills.

Responsabilidades

• Oversee billing, coding, claims submission, cash posting, and AR.
• Monitor KPIs: DSO, clean claim rate, denial rate, net collection rate.
• Lead billing and collections with outsourced providers.
• Ensure coding accuracy and compliance with ICD-10, CPT, HCPCS.
• Analyze denial trends and implement root-cause strategies.
• Maintain payment integrity through accurate posting and cash reconciliation.
• Collaborate with Patient Access and Decision Support for pricing estimates.
• Develop and mentor revenue cycle teams; drive continuous improvement.

Conhecimentos

Leadership

Revenue cycle optimization

Analytical thinking

Cross-functional collaboration

Strategic thinking

Formação académica

Bachelor's degree in Business, Finance, Accounting, Healthcare Information Management, Information Systems, Mathematics, Statistics, or related field

Ferramentas

Revenue cycle software

Descrição da oferta de emprego

Director of Revenue & Reimbursement

Healthcare Leadership | Revenue Cycle Operations | Billing & Reimbursement

Are you an experienced healthcare revenue cycle leader who knows how to improve reimbursement, strengthen financial performance, and lead effective billing and collections operations?

We are seeking a Director of Revenue Cycle to oversee back-end revenue cycle operations for a healthcare organization. Reporting directly to the CFO, this leader will drive operational excellence across billing, coding, claims management, cash posting, accounts receivable, denial resolution, and revenue integrity.

The ideal candidate brings strong healthcare revenue cycle expertise, analytical skills, and the ability to collaborate across clinical, financial, and operational teams to optimize reimbursement while maintaining compliance and accuracy.

What You'll Do

• Lead Revenue Cycle Operations: Oversee billing, coding, charge capture, claims submission, cash posting, and accounts receivable.
• Improve Financial Performance: Monitor and improve key performance indicators, including days in A/R, clean claim rate, denial rate, and net collection rate.
• Oversee Billing & Collections: Partner with outsourced service providers to ensure timely claims submission, effective follow-up, and resolution of aging accounts and underpayments.
• Ensure Coding Accuracy & Compliance: Oversee ICD-10, CPT, and HCPCS coding processes, audits, and corrective action initiatives.
• Drive Denial Prevention: Analyze denial trends, identify root causes, and implement strategies to reduce recurring denials and revenue leakage.
• Maintain Payment Integrity: Ensure accurate payment posting, contractual adjustments, cash reconciliation, and accounts receivable reporting.
• Support Revenue Integrity: Partner with Patient Access and Decision Support teams to improve charge capture, pricing estimates, and reimbursement accuracy.
• Oversee Bad Debt & Financial Assistance: Manage related workflows, vendor relationships, write-offs, and appropriate account classifications.
• Deliver Financial Insights: Own revenue cycle dashboards, reporting, and analytics while partnering with the CFO on revenue performance and forecasting.
• Lead & Develop Teams: Provide direction to internal billing, coding, and cash posting staff, establish performance expectations, and promote continuous improvement.

What We're Looking For

• Bachelor's degree in Business, Finance, Accounting, Healthcare Information Management, Information Systems, Mathematics, Statistics, or a related field preferred.
• At least 7 years of relevant healthcare experience, with strong knowledge of revenue cycle operations and healthcare reimbursement.
• In-depth knowledge of HCPCS and ICD-10 coding, reimbursement practices, and applicable regulatory requirements.
• Experience analyzing financial information, interpreting financial statements, and using revenue cycle data to improve performance.
• Strong understanding of billing, claims, collections, and revenue cycle information systems.
• Demonstrated ability to connect clinical documentation, coding, billing, and financial processes to improve compliance and maximize reimbursement.
• Experience managing teams, third-party vendors, and cross-functional relationships.
• Strong analytical, organizational, communication, and problem-solving skills.

Preferred Certifications:

RHIA, RHIT, RN, CPC, CPC-H, CCS, or CCS-P.

Why This Opportunity?

• Leadership visibility and direct partnership with the CFO.
• The opportunity to influence revenue cycle strategy and financial outcomes.
• A role that combines operational leadership, analytics, compliance, and team development.
• The ability to drive meaningful improvements in reimbursement performance and operational efficiency.

Interested in making an impact on healthcare financial performance?