Director of Revenue Cycle Management

Vendor Management & Performance

• Own operational oversight of multiple outsourced RCM vendors supporting AR follow-up, denial/underpayment work queues, payment posting, and remittance reconciliation across the platform.
• Translate enterprise goals into clear vendor expectations, work standards, productivity requirements, and service levels; ensure adequate staffing, coverage, and contingency planning.
• Establish and run recurring vendor operating rhythms (daily/weekly huddles, monthly QBRs), including KPI reviews, root-cause analysis, and corrective action plans.
• Monitor vendor quality through audits and controls (posting accuracy, contractual allowance mapping, denial code accuracy, adjustment integrity, refund processing, reconciliation completeness).
• Ensure vendors comply with Evolve policies, payer rules, HIPAA/security requirements, and documentation standards; escalate and resolve issues quickly.
• Partner with Finance/Treasury and vendor teams to ensure cash application integrity, bank deposit/lockbox alignment, ERA/EFT enrollments, and timely reconciliation of exceptions.
• Support contract administration by reviewing vendor invoices against deliverables, validating performance, and recommending optimizations or scope changes to maximize value.

AR Strategy, Denials Management & Cash Acceleration

• Drive consistent AR work standards across practices (aging prioritization, escalation pathways, payer strategy playbooks, timely filing safeguards, appeal processes).
• Oversee denial and underpayment management, including identification of trends, root causes, and cross-functional fixes with Coding, Charge Entry, Patient Access, and Operations.
• Ensure appropriate handling of credit balances, refunds, recoupments, and patient overpayments; maintain controls that protect against write-off leakage and compliance risk.
• Partner with leadership to set targets for aging buckets (30/60/90+), denials rates, and cash velocity; develop and execute action plans to achieve targets.
• Support payer issue escalation and complex claim resolution, including high-dollar accounts, out-of-network scenarios, retro-authorizations, and post-payment audits.

Payment Posting, Reconciliation & Controls

• Ensure accurate and timely posting of ERAs/EOBs, including payments, adjustments, contractuals, takebacks, interest, and patient responsibility.
• Lead reconciliation processes that ensure posted activity matches payer remits, bank deposits, lockbox files, and merchant services reports; investigate and resolve variances.
• Partner with IT/PM teams to maintain payer mappings, posting rules, and reconciliation workflows; ensure changes are tested and validated prior to release.
• Develop and maintain audit trails and control documentation that supports internal and external audits.
• Oversee refund workflow controls, including payer vs patient refunds, approvals, and reconciliation to GL as applicable.

Reporting, Analytics & Continuous Improvement

• Own operational reporting cadence for assigned functions; validate data integrity and ensure stakeholders receive accurate, actionable KPI reporting.
• Build and maintain dashboards for vendor KPIs and revenue cycle performance (cash posted, cash collected, denial trends, AR aging, reconciliation exception queues, turnaround times).
• Identify system/process defects and drive fixes with cross-functional partners; create standard work, SOPs, and training materials as processes evolve.
• Support integrations, acquisitions, and practice conversions by partnering on workflow design, vendor onboarding, and go-live stabilization plans.

Leadership & Collaboration

• Serve as a key RCM leader for the MSO, modeling accountability, urgency, and a service mindset across practices.
• Cook with Patient Access, Coding, Charge Entry, Clinical Operations, and Finance to ensure clean claim flow and timely resolution of issues impacting cash.
• Escalate risks and opportunities to the VP, RCM with clear analysis, recommendations, and expected impact.
• Lead special projects and ad hoc analyses as assigned, including payer initiatives, workflow redesign, and performance improvement sprints.