Why You’ll Love This Job
Are you a strategic leader in healthcare revenue cycle management looking for a remote opportunity where you can drive innovation and optimize financial performance? Do you thrive in a fast-paced, high-growth environment where you can lead process improvements, manage vendor partnerships, and implement cutting-edge AI-driven solutions?
We’re seeking a Director of Revenue Cycle Management to play a key role in shaping the financial success of our organization. Reporting to the CFO, this position will lead revenue cycle operations, oversee vendor relationships, and spearhead the transition of coding functions in-house using AI technology. If you have a track record of boosting revenue, reducing denials, and enhancing efficiency in emergency and urgent care settings, we want to hear from you!
This is a remote-based leadership opportunity for a data-driven, results-oriented professional looking to make a meaningful impact in healthcare.
Ready to take your career to the next level? Apply today!
Responsibilities
- Vendor Oversight and Management
- Manage relationships with third-party vendors responsible for coding, billing, and collections. Ensure vendors meet established KPIs, SLAs, and compliance standards.
- Evaluate vendor performance regularly, identify gaps, and implement corrective action plans.
- Develop and maintain redundancy across services by partnering with at least two vendors for each function to mitigate risks.
- Deep dive into individual claims / QC to ensure effective actions at vendor level.
- Strategic Leadership and Process Improvement
- Develop and implement a comprehensive revenue cycle management strategy aligned with the company’s financial goals and objectives.
- Identify opportunities for process optimization and lead initiatives to improve revenue, collections, and the timeliness of collections.
- Drive the transition of coding functions from outsourced vendors to an internal team utilizing AI technology, in collaboration with an external AI partner.
- Implement data-driven strategies to enhance revenue integrity and reduce denials.
- In-House Coding Implementation
- Lead the integration of an automated digital tool-driven coding solution in partnership with an external provider.
- Recruit, train, and manage 1-2 in-house coders who will work alongside the AI solution to ensure coding accuracy, compliance, and efficiency.
- Monitor the AI solution’s performance and make adjustments as needed to optimize accuracy and productivity.
- Financial Analysis and Reporting
- Analyze revenue cycle data to identify trends, issues, and areas for improvement.
- Provide regular reports to executive leadership on RCM performance, including revenue, collections, days in A/R, and other key metrics.
- Develop and maintain dashboards and KPIs to track the effectiveness of RCM initiatives and vendor performance.
Skills & Qualifications
- Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or a related field; Master’s degree preferred.
- Minimum of 8-10 years of progressive experience in revenue cycle management within the healthcare industry, with a focus on emergency room and urgent care settings.
- Demonstrated experience managing third-party vendors for coding, billing, and collections services.
- Expertise in bringing coding functions in-house and implementing AI-driven solutions for revenue cycle management.
- Strong analytical skills with the ability to interpret complex data and translate it into actionable insights and strategies.
- Proven track record of driving improvements in revenue capture, collections, and reducing days in A/R.
- Excellent leadership and team management skills, with experience leading cross-functional teams and managing change in a complex environment.
- Deep understanding of healthcare reimbursement, coding (CPT, ICD-10), billing processes, compliance, and payer regulations; experience with payer negotiation is a plus.