Director, Revenue Accounting

Responsibilities

• Revenue Recognition & Accounting Leadership
• Oversee revenue recognition for FFS, capitation, shared savings, quality incentives, and risk-adjusted revenue.
• Ensure compliance with GAAP, healthcare revenue accounting standards, and payor contract requirements.
• Lead monthly and quarterly revenue close processes, including accruals, reconciliations, and variance analysis.
• Develop and maintain accounting policies for both traditional and alternative payment models.
• Fee-for-Service (FFS) Revenue Oversight
• Partner with Revenue Cycle to ensure accurate charge capture, coding, billing, and collections.
• Monitor denials, underpayments, and payor behavior to ensure accurate net revenue.
• Oversee reconciliation of billed vs. recognized revenue and identify trends impacting financial performance.
• Value-Based Care (VBC) Revenue Oversight
• Lead accounting for shared savings, downside risk, quality bonuses, risk adjustment, and attribution-based payments.
• Manage payor settlements, reconciliation statements, and dispute resolution.
• Collaborate with Population Health and Actuarial teams to validate performance metrics and financial projections.
• Ensure accurate accruals for expected VBC revenue based on utilization, quality, and risk scoring.
• Financial Reporting & Analysis
• Produce executive-level reporting on revenue performance across FFS and VBC portfolios.
• Analyze trends in utilization, payor mix, risk scores, and contract performance.
• Support budgeting and forecasting for both traditional and alternative reimbursement streams.
• Provide insights to leadership on revenue risks, opportunities, and strategic implications.
• Cross-Functional Collaboration
• Work with Contracting to evaluate payor agreements and financial impact.
• Partner with Clinical Operations and Population Health to connect financial outcomes with care delivery initiatives.
• Collaborate with IT/Data teams to ensure integrity of claims, encounter, and attribution data.
• Leadership & Team Development
• Lead and mentor a team of revenue accountants.
• Build scalable processes and internal controls to support organizational growth.
• Foster a culture of accuracy, accountability, and continuous improvement.

  Qualifications

  • Bachelor’s degree in accounting, Finance, or related field.
  • 4+ years of progressive accounting experience preferably in healthcare.
  • Knowledge of FFS reimbursement, VBC models, and GAAP a plus.
  • Some experience with revenue recognition for capitation, shared savings, and risk-based contracts.
  • Leadership experience managing accounting or revenue teams.
  • CPA or MBA.
  • Experience in a health system, large medical group, ACO, MSO, or payor.
  • Familiarity with risk adjustment methodologies, actuarial concepts, and claims analytics.
  • Knowledge of ERP systems and healthcare revenue tools.
  • Technical accounting expertise.
  • Deep understanding of healthcare reimbursement.
  • Risk-based contract analysis.