Director of Revenue Cycle Management

This is a fully remote position, open to applicants in United States.

📋 Description

• Direct and enhance Boulder Care's comprehensive revenue cycle operations to maximize cash collections and ensure sustainable financial success.

• Manage the Revenue Cycle Manager and provide strategic guidance on patient billing, coding, collections, payer operations, revenue integrity, and revenue cycle analytics.

• Cultivate partnerships with Candid and other technology providers to enhance system functionality and automate workflows.

• Supervise charge capture, coding assistance, claims management, payment posting, denials handling, appeals, collections, and revenue integrity.

• Create initiatives to boost revenue cycle performance, cash flow, and operational efficiency.

• Set revenue cycle objectives and KPIs, promoting accountability, continuous improvement, and superior customer service.

• Counsel the Controller and executive team on reimbursement trends, payer performance, cash flow enhancement, and revenue cycle vulnerabilities.

• Track dashboards and analytics; assess revenue, collections, denial rates, aging, reimbursement, and payer performance.

• Enhance net collections and minimize revenue leakage.

• Collaborate with Accounting on monthly closure, revenue recognition, accounts receivable assessment, allowance methodologies, and audit support.

• Assist with budgeting, forecasting, and financial planning for revenue operations.

• Ensure compliance in billing and collections with healthcare regulations, Medicare, Medicaid, payer agreements, HIPAA, internal policies, and GAAP controls.

• Collaborate with Compliance and Legal on regulatory changes related to reimbursement.

• Review workflows and implement Lean or other continuous improvement strategies.

• Work with Product, Engineering, and Technology on system automation and functionality enhancements.

• Oversee third-party billing vendors and outsourced revenue cycle partners.

• Ensure prompt resolution of payer issues and escalated billing inquiries.

• Mentor and develop revenue cycle leaders and staff; set expectations and conduct performance evaluations.

• Create succession plans and encourage employee development.

• Collaborate with Accounting, FP&A, Clinical Operations, Credentialing, Provider Operations, Compliance, Product, and Engineering.

• Support new payer agreements, clinical programs, and operational initiatives.

• Present revenue cycle performance, strategic initiatives, and operational metrics to Finance leadership and executive management.

⛳️ Requirements

• 8+ years of advancing healthcare revenue cycle experience.

• 4+ years of leadership experience overseeing revenue cycle teams.

• Strong grasp of healthcare reimbursement methodologies, including commercial insurance, Medicare, Medicaid, and value-based reimbursement models.

• Experience in managing denials, collections, payer relationships, and revenue integrity initiatives.

• Excellent financial acumen and ability to analyze operational and financial metrics.

• Familiarity with healthcare billing systems and electronic health records (EHRs).

• Exceptional analytical, communication, leadership, and relationship management skills.

• Bachelor's degree in Accounting, Finance, Healthcare Administration, Business Administration, or a related field is preferred.

• Experience in startups, behavioral health, substance use disorder treatment, or value-based care is preferred.

• Experience with Candid or similar web-based healthcare billing applications is preferred.

• Familiarity with Athenahealth, Salesforce, or comparable healthcare platforms is preferred.

• Understanding of ASC 606 revenue recognition and GAAP financial reporting is preferred.

• HFMA CRCR, CHFP, or other relevant healthcare revenue cycle certifications are preferred.

• Ability to sit and/or stand for extended durations.

• Ability to view a computer screen for prolonged periods to prepare and analyze data, transcribe information, and read.

• Final candidates must complete background checks and provide professional references.

🏝️ Benefits

• Comprehensive medical, dental, vision, and short-term disability benefits.

• Mental Health Services through insurance coverage, including Talkspace and EAP.

• 4 weeks of vacation accrued each calendar year, increasing to 5 weeks after 2 years of employment.

• Sick leave accrued at a rate of 1 hour for every 30 hours paid.

• 9 paid holidays each year.

• 12 weeks of fully paid parental leave after 6 months of employment.

• 401(k) retirement savings plan.

• Remote-friendly work environment.

• Hardware provided to fulfill work responsibilities.

• Opportunity to engage in meaningful, life-saving work.