Director of Revenue Cycle Management

Position Overview

The Director of Revenue Cycle Management will oversee the full revenue cycle, including claims processing, collections, payer contracting, credentialing, and denial management. This hands-on leadership role manages the billing team, drives revenue performance, ensures regulatory compliance, and partners with operations and technology teams to improve workflows and automate billing processes.

Key Responsibilities

• RCM Leadership: Lead, coach, and manage the billing team while establishing productivity, accuracy, and quality standards.
• Revenue Performance: Own collection targets and monitor key metrics, including clean claim rate, denial rate, days in accounts receivable, and net collection rate.
• Claims & Collections: Oversee the full claims lifecycle, including charge capture, claim submission, payment posting, denials, appeals, and follow-up.
• Payer Contracting & Credentialing: Manage payer relationships, contract negotiations, and provider credentialing processes.
• Denial Management & Compliance: Identify root causes of rejections and denials, implement corrective actions, and ensure compliance with CMS guidelines and payer requirements.
• Process Improvement & Automation: Collaborate with operations and engineering teams to streamline billing workflows, improve reporting, and prevent avoidable denials.
• Leadership Reporting: Provide regular updates on revenue performance, collection trends, and improvement initiatives.

Qualifications

• 5+ years of healthcare revenue cycle management experience, including at least 2 years leading a billing or collections team.
• Strong hands-on experience with Medicare and Medicare Advantage billing.
• Experience with payer contracting, provider credentialing, claims management, and denial resolution.
• Proven track record of improving collections and reducing denials.
• Strong analytical, leadership, communication, and problem-solving skills.
• Proficiency with RCM reporting, dashboards, and performance metrics.
• Interest in leveraging technology and automation to improve revenue cycle operations.

Preferred Qualifications

• Experience with care management or time-based billing codes, such as PIN, CHI, CCM, or PCM.
• Background in care navigation, value-based care, digital health, or startup environments.
• Experience scaling revenue cycle operations in a growing organization.