Senior Director, Revenue Cycle Managed Services – RC Ambulatory

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

📋 Description

• Oversee the complete revenue cycle operations for a medical group.

• Manage registration, eligibility checks, authorizations, coding processes, billing, collections, denials, payment posting, credits, refunds, and patient financial services.

• Create and implement strategies to enhance cash flow, decrease days in accounts receivable, reduce denial rates, boost net collection rates, and improve financial performance.

• Set, track, and report on revenue cycle performance metrics.

• Collaborate with physicians, practice administrators, finance, compliance, coding, credentialing, contracting, IT, and operations leaders.

• Ensure compliance of billing, coding, claims, collections, and documentation with regulations, payer requirements, HIPAA, Medicare, Medicaid, and internal standards.

• Supervise denial prevention and resolution, root-cause analysis, appeals, payer trend analysis, and corrective action plans.

• Direct escalation of payer issues, reimbursement analysis, contract performance monitoring, and cooperation with managed care or contracting teams.

• Lead optimization of revenue cycle systems, workflow redesign, automation, reporting improvements, and implementation of new technologies.

• Prepare executive reports, financial analyses, dashboards, forecasts, and actionable recommendations.

• Formulate policies, procedures, training materials, audit processes, and internal controls.

• Manage, mentor, and develop revenue cycle managers, supervisors, analysts, and staff members.

• Assess and manage billing, clearinghouse, collection agency, technology, and outsourced service providers.

• Support budgeting, staffing models, resource planning, productivity standards, and workforce development.

• Identify operational risks, financial trends, and opportunities for process enhancement.

• Lead cross-departmental initiatives aimed at improving revenue integrity and patient satisfaction.

• Travel to client sites as required, estimated at 25%.

⛳️ Requirements

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

• 10–15 years of progressive experience in healthcare revenue cycle management.

• At least 5 years of leadership experience in revenue cycle management, overseeing teams, supervisors, or managers.

• Comprehensive understanding of professional billing, coding processes, charge capture, payer reimbursement, claims adjudication, denial management, patient collections, and accounts receivable management.

• Proven track record of enhancing revenue cycle performance metrics, operational efficiency, cash collections, and compliance results.

• Experience with electronic health records, practice management systems, clearinghouses, reporting tools, and revenue cycle software.

• Familiarity with Medicare, Medicaid, commercial payer guidelines, HIPAA, compliance requirements, and relevant billing regulations.

• Strong analytical, financial, problem-solving, communication, and executive presentation skills.

• Capable of leading change, influencing stakeholders, managing competing priorities, and achieving measurable outcomes across various sites or specialties.

• A Master’s degree is preferred.

• Relevant certifications such as Revenue Cycle, HFMA, MGMA, AAPC, AHIMA, CHFP, CRCR, CPC, or equivalent are preferred.

• Experience in supporting multispecialty physician groups, hospital-owned practices, or large ambulatory networks is preferred.

• Background in leading system conversions, revenue cycle transformation projects, centralization initiatives, or automation programs is preferred.

• Knowledge of value-based care, risk-based contracts, payer contracting, provider enrollment, credentialing, and revenue integrity initiatives is preferred.

🏝️ Benefits

• An annual performance bonus may be available for salaried positions.

• Additional benefits and perks may be available based on the position and employment terms.

• A caring, enjoyable, honest, and autonomous work environment.

• A diverse and inclusive atmosphere where employees feel valued and empowered.