Director of Revenue Cycle Management

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

📋 Description

• Oversee the complete Revenue Cycle Management (RCM) process for both Medicaid and Medicare, from eligibility and authorization to claims, denials, and collections.

• Direct RCM strategy, which includes team development, recruitment, management of RCM personnel, KPI formulation and reporting, as well as collaboration across various functions.

• Examine claims data to pinpoint areas for improvement, enhance collection rates, and reduce Days Sales Outstanding (DSO).

• Supervise patient billing and the collection of coinsurance fees.

• Manage denial processes and appeals, aiming to lower rejection and denial rates.

• Centralize the processes of eligibility verification, authorizations, and payer reporting within RCM.

• Collaborate directly with payers and provider groups to resolve claims issues and maintain payer reporting relationships.

• Work alongside the Finance team on revenue reconciliation, cash application, and collection reporting.

• Ensure adherence to Medicaid and Medicare billing regulations.

• Choose, implement, and enhance RCM systems to support multi-program billing and organizational growth.

• Develop scalable and automated processes suited for a rapidly evolving startup environment.

• Report directly to the VP of Finance and BizOps.

⛳️ Requirements

• A minimum of 8 years of progressive experience in Revenue Cycle Management (RCM), demonstrating end-to-end ownership in areas including eligibility/enrollment, charge capture, coding, claims submission, denial management, and collections.

• Extensive, practical knowledge of Medicaid and Medicare billing throughout the entire revenue cycle, ideally encompassing Fee-for-Service (FFS), risk-based arrangements, and various healthcare billing frameworks.

• Proven experience in building and leading teams within a high-growth, early-stage startup setting.

• Capability to independently query and analyze claims data, derive insights, and implement improvements in collection rates.

• Excellent communication and collaboration abilities across finance, accounting, operations, product, and engineering disciplines.

• Familiarity with RCM solutions such as Candid, Waystar, etc.

• A results-driven mindset with a strong sense of ownership.

• Ability to excel in a dynamic, complex, and low-red-tape early-stage environment.

• A genuine passion for supporting individuals with complex chronic needs, including homelessness, severe mental illness, and substance use disorders.

• E-Verify employment eligibility verification is mandatory for new hires.

• Successful completion of a pre-employment background check is required.

🏝️ Benefits

• Equity compensation package.

• Comprehensive medical, dental, and vision plans with HSA/FSA options and company contributions to HSA.

• Remote-first work environment with equipment provided and a $100/month home office stipend.

• Flexible paid time off (PTO) and 12 paid holidays.

• Fully company-funded life, disability, and AD&D insurance.

• Access to backup childcare, caregiver concierge services, and financial guidance resources.