Revenue Cycle CBO Director

About the Role

You are someone who is passionate about bringing end-to-end Revenue Cycle Central Business Office services together to improve financial performance, operational excellence, and the patient financial experience. We need someone who can lead and develop high-performing teams and use data and operational insights to drive results. In this role, you will help shape an evolving CBO model and make a meaningful impact on the financial strength and long-term sustainability of rural healthcare.

Responsibilities

• End-to-End Revenue Cycle Leadership
  • Lead end-to-end revenue cycle performance across Patient Access, Coding/CDI, Revenue Integrity, and PFS within the TRC CBO.
  • Identify upstream and downstream drivers of revenue leakage, denials, payment delays, and patient financial friction and drive cross-functional improvement.
  • Establish standardized workflows, controls, service levels, escalation pathways, and performance accountability across participating hospitals.
  • Serve as the accountable CBO operational leader while developing functional Managers as owners of domain performance and execution.
  • Serve as an executive-facing leader, translating complex revenue cycle performance into clear, compelling narratives, insights, and recommendations for Monthly Operating Reviews, Hospital Boards, C-Suite executives, and other internal and external executive stakeholders.
• Critical Access Hospital & Reimbursement Leadership
  • Apply strong knowledge of CAH reimbursement, including cost-based reimbursement and requirements across inpatient, swing bed, outpatient, emergency, observation, and other in-scope services.
  • Anticipate payer, regulatory, reimbursement, and operational changes affecting rural hospitals and translate impacts into effective operational response.
• Front End – Patient Access
  • Provide leadership and oversight for in-scope Patient Access functions, including registration, eligibility and benefits verification, prior authorization, medical necessity, financial clearance, patient estimates, financial counseling, and point-of-service collections.
  • Drive front-end accuracy and timely financial clearance to support clean claims, reduce avoidable denials, accelerate cash, and improve the patient financial experience.
  • Establish performance standards and root-cause processes for authorization, eligibility, registration accuracy, medical necessity, and point-of-service collection performance.
  • Partner with hospital-retained and clinical teams when upstream workflows affect CBO outcomes.
• Middle Revenue Cycle – Coding, CDI & Revenue Integrity
  • Lead Coding and CDI across participating CAHs, including inpatient, swing bed, outpatient, emergency, observation, clinic, and professional coding as applicable to scope.
  • Ensure timely, accurate, and compliant coding and documentation through effective quality, productivity, audit, education, provider query, and CDI practices.
  • Drive coding- and documentation-related DNFB reduction, claim edit resolution, denial prevention, and root-cause improvement in partnership with providers, clinical leadership, Case Management, and hospital-retained HIM.
  • Oversee revenue integrity, including charge capture and reconciliation, charging controls, revenue-related edits, and identification and prevention of revenue leakage.
  • Partner across Patient Access, Coding/CDI, PFS, clinical departments, Finance, and hospital leadership to identify systemic issues and implement sustainable corrective action.
• Back End – Patient Financial Services & Payer Performance
  • Lead billing, insurance follow-up, AR, denials and appeals, underpayments, payment posting, credit balances, refunds, and self-pay operations.
  • Drive payer-specific account resolution and escalation strategies to improve cash, reduce aging and avoidable write-offs, and maximize appropriate reimbursement.
  • Monitor denial trends, payment variances, payer behavior, and reimbursement changes to identify risk and drive corrective action.
  • Translate payer and account-resolution insights into upstream improvements across Patient Access, Coding/CDI, Revenue Integrity, and other hospital stakeholders.
• Operational Performance & Executive Reporting
  • Establish and manage CBO performance through clear KPIs, productivity, quality, service levels, and financial targets.
  • Use data and operational insights to identify performance gaps, quantify impact, prioritize action, and measure improvement.
  • Lead operational reviews, clearly communicating performance, risks, corrective actions, and decisions needed while holding leaders accountable for results.
• Technology, Analytics & Operational Optimization
  • Partner with Strategic Operations, Product, and technology teams to identify and implement solutions that improve revenue cycle performance.
  • Leverage data, dashboards, and operational intelligence to manage performance, prioritize action, and identify operational risk.
  • Champion adoption of technology, automation, and AI-enabled solutions within CBO operations and ensure effective integration into frontline workflows.
  • Provide operational feedback and performance insights to support ongoing optimization and value realization.
• Vendor, Service Level & Partner Management
  • Oversee performance of third-party revenue cycle vendors and outsourced services within scope, including clear expectations, service levels, quality standards, escalation processes, and performance reviews.
  • Ensure vendor performance is transparent, measurable, and aligned with TRC financial, operational, compliance, and patient experience objectives.
  • Identify vendor-related risks, gaps, duplication, or opportunities for consolidation and improvement.
  • Coordinate with internal and hospital stakeholders to resolve issues that cross organizational or contractual boundaries.
• Compliance & Operational Controls
  • Ensure CBO operations adhere to regulatory, payer, billing, coding, organizational, and internal control requirements.
  • Partner with Compliance, Finance, and hospital leadership to address risks, corrective actions, and audit readiness.
  • Maintain effective operational controls and promptly escalate material compliance, reimbursement, financial, or operational risks.
• People Leadership & Workforce Optimization
  • Lead, coach, and develop functional Managers, establishing clear accountability, decision rights, and performance expectations.
  • Build leadership capability in operational management, problem solving, data-driven decision-making, and associate development.
  • Optimize workforce capacity, staffing, productivity, skill mix, and succession to meet operational needs.
  • Foster a culture of accountability, collaboration, continuous improvement, service, and operational excellence.
• Hospital & Stakeholder Partnership
  • Serve as the senior operational liaison between the CBO and participating CAHs, building trusted relationships with hospital executives and key stakeholders.
  • Communicate revenue cycle performance, risks, opportunities, and action plans clearly and proactively.
  • Partner with hospital-retained functions to resolve issues, manage dependencies, and improve end-to-end revenue cycle performance.
  • Establish transparent service expectations, responsibilities, escalation pathways, and shared accountability for outcomes.
• Leadership Competencies
  • End-to-End Revenue Cycle Leadership: Connects front-, middle-, and back-end operations to drive financial, operational, and patient outcomes.
  • CAH & Payer Acumen: Understands rural/CAH operations, reimbursement, payer dynamics, denials, and revenue risk.
  • Performance & Transformation: Uses data, root-cause analysis, standardization, and change leadership to drive measurable and sustainable improvement.
  • People & Partnership Leadership: Builds accountable teams and trusted partnerships across CBO, hospital, clinical, and executive stakeholders.
  • Technology & AI-Enabled Optimization: Leverages systems, analytics, automation, and AI to improve performance, workforce effectiveness, and decision-making.

Requirements

• Bachelor's degree in healthcare administration, business, finance, or related field required; equivalent directly relevant experience may be considered.
• CRCR, CHFP, or other relevant revenue cycle certification preferred.
• 7–10+ years of progressive hospital revenue cycle experience, including 5+ years leading multi-functional, centralized, shared-services, or multi-hospital operations preferred.
• Demonstrated end-to-end knowledge across Patient Access, Coding/CDI, Revenue Integrity, and PFS, with experience managing cash, AR, denials, DNFB, coding performance, productivity, quality, and revenue improvement.
• Rural hospital/CAH experience strongly preferred, including working knowledge of CAH cost-based reimbursement and applicable rural reimbursement requirements.
• Experience with payer/denial and underpayment strategy, compliance, operational transformation, workflow standardization, performance improvement initiatives, and change leadership.
• Experience managing vendors/service levels and leveraging major EHR platforms (EPIC, Oracle, Meditech etc), analytics, automation, and AI-enabled technologies preferred.
• Experience managing third-party vendors, outsourced revenue cycle services, and service-level performance preferred.

Required Travel: 25-40% of time
Time Zone: Must be flexible to work PST zone hours.

Benefits

• Health Insurance
• Fully Paid Life Insurance
• Fully Paid Short- & Long-Term Disability
• Paid Vacation
• Paid Sick Leave
• Paid Holidays
• Professional Development and Tuition Assistance Program
• 401(k) Program with Employer Match