Director of Revenue Cycle

Lighthouse Lab Services is currently seeking a Revenue Cycle Manager in the Miami FL area to oversee all revenue cycle operations for a CLIAcertified molecular diagnostics laboratory. This includes managing the complete billing lifecyclefrom patient intake and prior authorizations to claim submission reimbursement and collections. The Manager will ensure that all billing practices for molecular and genetic testing services are compliant with evolving federal and payerspecific regulations. This role requires deep understanding of molecular CPT coding prior authorization workflows and thirdparty payer intricacies related to highcomplexity laboratory testing.

The Manager will ensure accurate and timely billing reduce days in accounts receivable and maximize reimbursements. This individual will also collaborate closely with laboratory operations research teams compliance and commercial staff to align financial goals with operational excellence.

Key Responsibilities:

• Develop and execute revenue cycle strategies tailored to the complexities of molecular diagnostics including genetic PCR and NGS testing.

• Oversee all RCM operations including patient intake benefits verification prior authorization coding billing payment posting and denial management.

• Ensure proper use of CPT and HCPCS codes for molecular and genetic tests staying updated on AMA and CMS changes.

• Work with payers to manage and negotiate molecular test reimbursement including appeals and supporting documentation requirements.

• Monitor KPIs such as clean claim rate denial rate days in A/R net collection rate and reimbursement per test.

• Ensure full compliance with CLIA HIPAA OIG CMS and commercial payer policies.

• Partner with IT and LIMS teams to ensure data accuracy and seamless claim workflows.

• Provide strategic input on pricing payer policy trends and coverage analysis for new and existing test offerings.

• Lead and mentor revenue cycle staff focusing on training development and performance.

• Support financial forecasting and reporting for senior leadership.

Qualifications:

Education:

• Bachelors degree in healthcare administration business finance or related field required.

• Masters degree (MBA MHA or equivalent) preferred.

Experience:

• Minimum of 58 years of progressive experience in revenue cycle management ideally in a molecular or clinical lab setting.

• At least 13 years of experience in a leadership or managerlevel RCM role.

• Indepth understanding of molecular test coding ZCodes and insurance preauthorization processes.

• Experience working with commercial payers and Medicare/Medicaid on complex lab test reimbursement.

• Familiarity with LIMS EHR systems (Collaborative MD preferred) and lab billing platforms.

Skills & Competencies:

• Deep knowledge of payer policies and molecular reimbursement challenges.

• Strong leadership and team development abilities.

• Analytical thinker with proficiency in revenue cycle reporting and financial metrics.

• Effective communicator with experience working crossfunctionally with laboratory and commercial teams.

• Ability to drive process improvement and implement RCM best practices in a dynamic environment.

Working Conditions:

• Occasional travel may be required.

• This position is based in Miami with hybrid remote flexibility.

• Work involves frequent collaboration across clinical research and operational teams.

Compensation Benefits:

• 100k120k salary
• Health insurance (medical vision dental)
• Retirement plan
• PTO

About Us:

At Lighthouse Lab Services we offer solutions to help start grow and run clinical laboratories. Our recruiting team has over 21 years of proven success placing job seekers in positions ranging from entry level Medical Technologists to seasoned Laboratory Directors. We recruit nationwide for permanent and travel positions with clients ranging from small hospitals to large reference laboratories.

It is the policy of Lighthouse Lab Services to provide equal employment opportunity (EEO) to all persons regardless of age color national origin citizenship status physical or mental disability race religion creed gender sex sexual orientation gender identity and/or expression genetic information marital status status with regard to public assistance veteran status or any other characteristic protected by federal state or local law. In addition Lighthouse Lab Services will provide reasonable accommodations for qualified individuals with disabilities.

Lighthouse Lab Services

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