Director, Revenue Cycle Operations

Health Business Solutions

United States

Hybrid

USD 128,000 - 132,000

Full time

14 days+
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Benefits offered by this job

Medical insurance
Vision insurance
401(k)

Job summary

A healthcare solutions company is seeking a Director, Revenue Cycle Operations to oversee revenue cycle functions, mentor the team, and enhance operational efficiency. This role requires strong leadership and analytical skills, along with substantial experience in revenue cycle management. The ideal candidate will lead initiatives to optimize revenues and ensure compliance within the industry. A bachelor's degree and 7+ years of relevant experience are essential for this position.

Qualifications

  • 7+ years of experience in revenue cycle management, with at least 3 years in a leadership role.
  • Strong understanding of healthcare billing and coding, payer regulations, and revenue cycle processes.
  • Proven experience in developing and implementing process improvements.

Responsibilities

  • Oversee all functions of the revenue cycle, including billing, coding, and collections.
  • Lead, manage, and mentor the revenue cycle management team.
  • Develop and implement strategies to improve revenue cycle processes.

Skills

Leadership
Analytical skills
Problem-solving
Communication

Education

Bachelor’s degree in Business Administration, Healthcare Management, Finance

Tools

Revenue cycle management software
Epic
Cerner

Job description

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The Revenue Cycle Operations Director will oversee all aspects of the revenue cycle, from billing and coding to claims processing and collections. This role will be responsible for ensuring the efficiency, accuracy, and financial integrity of revenue cycle processes, driving improvement initiatives, and ensuring compliance with industry regulations. The Director will collaborate with key departments such as business intelligence, sales, and operations to optimize revenue cycle functions and align with the overall company strategy.

Key Responsibilities:

  • Leadership and Strategy:
  • Lead, manage, and mentor the revenue cycle management team, ensuring a high level of engagement and productivity.
  • Develop and implement strategies to improve revenue cycle processes, reduce denials, and enhance revenue capture.
  • Analyze revenue cycle trends, including key performance indicators (KPIs), to develop improvement strategies that align with company goals.

Revenue Cycle Management:

  • Oversee all functions of the revenue cycle, including patient registration, coding, billing, claims processing, payment posting, denial management, and collections.
  • Collaborate with departments such as operations, business intelligence, and sales to improve workflows and achieve revenue optimization.
  • Develop and maintain policies and procedures related to revenue cycle activities, ensuring compliance with healthcare regulations and payer requirements.
  • Ensure timely and accurate submission of claims and the effective management of accounts receivable to maintain optimal cash flow.
  • Work closely with the operations and business intelligence teams to create streamlined workflows and reduce operational inefficiencies.
  • Coordinate with the sales and growth department to identify new opportunities and ensure revenue cycle readiness for expanded service lines or contracts.

Process Improvement and Optimization:

  • Identify and implement revenue cycle improvements, using data-driven analysis to reduce claim denials, shorten revenue cycle time, and enhance payment collections.
  • Introduce automation or technological solutions where possible to improve efficiency in revenue cycle processes.
  • Monitor regulatory changes that impact revenue cycle operations and ensure compliance with federal, state, and payer guidelines.
  • Work closely with finance and executive leadership to create revenue cycle financial reports and contribute to strategic planning.
  • Manage and monitor the departmental budget, making adjustments as necessary to optimize resource allocation and performance.

Compliance and Reporting:

  • Ensure adherence to all federal, state, and local laws and regulations related to billing, coding, and collections.
  • Prepare and present regular reports on revenue cycle performance, including KPIs, for executive leadership.
  • Conduct audits to ensure the accuracy and integrity of revenue cycle operations.

Qualifications:

  • Bachelor’s degree in Business Administration, Healthcare Management, Finance, or a related field (Master’s preferred).
  • 7+ years of experience in revenue cycle management, with at least 3 years in a leadership role.
  • Strong understanding of healthcare billing and coding, payer regulations, and revenue cycle processes.
  • Proven experience in developing and implementing process improvements.
  • Excellent analytical, problem-solving, and decision-making skills.
  • Ability to work collaboratively with cross-functional teams and executive leadership.
  • Strong organizational and leadership abilities, with experience managing large teams.
  • Excellent communication and presentation skills.

Preferred Skills:

  • Familiarity with revenue cycle management software and tools (e.g., Epic, Cerner, Athena health).
  • Knowledge of healthcare revenue cycle KPIs and best practices for improving metrics like Days in Accounts Receivable (AR), denial rates, and collections.
Seniority level
  • Seniority level
    Director
Employment type
  • Employment type
    Full-time
Job function
  • Job function
    Management and Finance
  • Industries
    Hospitals and Health Care and Insurance

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

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