Director of Revenue Cycle

Key Responsibilities

• Direct and oversee all revenue cycle functions including:
• Coding
• Charge capture
• Billing
• Claims submission
• Payment posting
• Collections
• Denials management
• Appeals management
• Reimbursement optimization
• Personal Injury account management
• Ensure timely and accurate claims processing and reimbursement across all payers.
• Oversee accounts receivable management with a focus on reducing Days in A/R and improving cash collections.
• Develop and implement revenue cycle workflows, policies, and best practices to improve efficiency and scalability.
• Analyze claims, reimbursement, payer mix, and collection trends to identify opportunities for revenue enhancement.
• Maintain oversight of documentation, coding accuracy, audit readiness, and reimbursement integrity.
• Interface directly with commercial payers, attorneys, workers’ compensation carriers, and personal injury representatives regarding claims, reimbursement disputes, escalations, and operational issues.
• Evaluate service line profitability and reimbursement performance across orthopedic and ASC offerings.
• Provide strategic recommendations to improve margin, reimbursement, and operational efficiency.
• Ensure coding and billing compliance with federal, state, payer, and specialty-specific regulations.
• Partner with compliance and clinical leadership on coding education and audit initiatives.

Qualifications

• Bachelor's degree in healthcare administration, Finance, Business, or related field required; master's degree preferred.
• 7+ years of progressive revenue cycle leadership experience in physician practice and/or ASC settings.
• Orthopedic practice revenue cycle experience strongly preferred.
• Demonstrated expertise in:
• Professional and facility coding/billing
• Claims reimbursement
• Denials and appeals
• Accounts receivable management
• Revenue cycle analytics
• Strong working knowledge of:
• Personal Injury (PI) billing/workflows
• Workers’ Compensation (WC) billing/workflows
• Experience with Athenahealth and SIS (Surgical Information Systems) a plus.
• Deep understanding of payer reimbursement methodologies and managed care operations.
• Strong analytical, financial modeling, and dashboard/reporting capabilities.
• Proven leadership experience managing managers/supervisors and larger operational teams.
• Preferred Certifications: CPC, CCS, CPMA, CRCR, HFMA, or other relevant revenue cycle/coding certifications preferred.

Key Competencies

• Strategic Financial Acumen
• Revenue Optimization
• Operational Excellence
• Data-Driven Decision Making
• Team Leadership & Development
• Payer Negotiation Support
• Process Improvement / Lean Thinking
• Executive Communication / Presentation Skills
• Personal Injury Experience

Success Metrics

• Improvements in:
• Net Collection Rate
• Days in Accounts Receivable
• Denial Rate / Appeal Success Rate
• Underpayment Recovery
• Coding Accuracy / Audit Scores
• Service Line Margin Performance
• Team Productivity / KPI Achievement

Why Join Us?

• Competitive benefits package including:
• Medical Insurance
• Vision and Dental Insurance
• 401(k) Retirement Plan
• Paid Time Off and Holidays
• Mileage Reimbursement for travel to satellite offices
• Compensatory Bonuses based on productivity and performance
• Competitive Pay: 110K-130K/yearly depending on qualifications and experience.