Senior Director of Revenue Cycle Management

About the role

The Senior Director of Revenue Cycle Management leads the billing, collections, and accounts receivable team while maintaining a comprehensive understanding of the company's billing systems and all aspects of revenue cycle management within a high-volume diagnostics laboratory environment.

Responsibilities

• Direct billing management and staff to ensure accurate submission of all claims and timely collections in accordance with all third-party contract terms including Medicare, Medicaid, managed care, commercial insurance, and direct patient pay.
• Lead the end-to-end diagnostics laboratory revenue cycle lifecycle — from test order and specimen receipt through charge capture, claim submission, adjudication, payment posting, denial resolution, and final collections.
• Establish and maintain all billing and financial data, including medical billing code tables, rate schedules, and payer information.
• Analyze reimbursement from all sources, including carrier reimbursement exception reporting, follow-up of pending claims, and denials management.
• Assure maximization of cash collections through diligent and timely monitoring of all open accounts receivable balances.
• Maintain and enhance billing policies and procedures for each function in the revenue cycle process and ensure staff adherence to policies.
• Manage continuous improvements within the revenue cycle process, leveraging Quadax's workflow automation and claim scrubbing and clearinghouse capabilities.

Requirements

• Bachelor's degree in Healthcare Administration, Business, Finance, or related field required.
• Master's degree (MBA, MHA) or CPA designation preferred.
• Certified Professional Coder (CPC), Certified Revenue Cycle Professional (CRCP), or equivalent certification strongly preferred.
• Ten (10) – fifteen (15) years of progressive revenue cycle leadership experience, with a minimum of 8 years managing a high-volume billing operation within a diagnostics laboratory, clinical laboratory, or pathology setting.
• Demonstrated expertise in the full diagnostics laboratory revenue cycle lifecycle, from test order intake and eligibility verification through claim submission, adjudication, denial management, and final collections.
• Extensive hands-on experience with Quadax RPM as the primary laboratory billing system, including system configuration, reporting, and workflow management.
• Extensive experience managing Quadax as a clearinghouse/billing vendor partner, including SLA oversight, denial management workflows, and outsourced billing coordination.
• Proven experience with benefits investigation processes in a laboratory or diagnostics setting, including prior authorization workflows and payer-specific BI requirements for high-complexity molecular and genomic assays.
• Proven experience with SOX compliance in a publicly traded company environment, including design and testing of revenue cycle internal controls over financial reporting (ICFR).
• Deep knowledge of CPT and ICD-10 coding for anatomic pathology, molecular diagnostics, and laboratory services.
• Extensive knowledge of Medicare, Medicaid, and commercial payer billing regulations, LCD/NCD policies, and laboratory-specific coverage requirements.

Qualifications

• Knowledge/Experience
• Preferred Skills & Competencies

Benefits

At Inform Diagnostics, we celebrate, support, and thrive on our differences. We are proud to be an equal opportunity workplace and an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or veteran status.

Pay

Competitive salary commensurate with experience.

Schedule

Full-time, Monday-Friday, 8:00 AM - 5:00 PM.