Revenue Cycle Management Director

General Summary

The Director of Revenue Cycle Management (RCM) provides enterprise-level leadership and strategic direction for all revenue cycle operations at Urology Centers of Alabama (UCA). This position is accountable for the performance integrity and continuous improvement of the full revenue cyclefrom charge capture and coding through billing collections and reimbursementensuring alignment with organizational financial goals regulatory requirements and best practices in healthcare revenue operations.

Unlike a managerial role focused primarily on daily workflows the Director establishes revenue cycle strategy performance standards monthly reporting and long-term optimization initiatives across all UCA entities and service lines. The Director partners closely with executive leadership physicians clinical operations compliance IT and finance to drive sustainable revenue growth mitigate compliance risk and enhance operational efficiency.

Key responsibilities include oversight of the entire revenue cycle process including: front desk collections prior authorization benefits verification coding accuracy denial management payment posting payer contract performance reimbursement optimization and EMR revenue integrity auditing. The Director develops and monitors key performance indicators (KPIs) leads system and process transformation initiatives and provides executive-level reporting and analysis to the CFO and senior leadership team.

Essential Functions

Strategic Revenue Cycle Leadership

1. Provide enterprise-level strategic leadership and oversight for all revenue cycle operations at Urology Centers of Alabama P.C. including registration charge capture coding billing claims submission payment posting denials management and collections.

2. Develop and execute revenue cycle strategies to maximize reimbursement reduce revenue leakage and improve cash flow

3. Establish monitor and report key performance indicators (KPIs) such as days in A/R clean claim rate denial rate net collection rate and reimbursement variance

EMR & Documentation Auditing

4. Lead ongoing audits of the EMR to ensure clinical documentation supports billed services medical necessity and compliance with payer and regulatory requirements

5. Partner with physicians and clinical leadership to address documentation gaps coding accuracy and workflow inefficiencies identified through EMR audits

6. Oversee pre- and post-billing audits to validate charge capture accuracy for urology-specific services including office visits procedures diagnostics surgeries and ancillary services

7. Ensure EMR templates order sets and workflows support compliant efficient and standardized revenue cycle processes across all locations

Reimbursement & Compliance Oversight

8. Audit reimbursements to ensure payments align with payer contracts fee schedules and applicable regulations

9. Identify underpayments and overpayments and lead recovery appeal and refund processes as required

10. Monitor payer trends reimbursement changes and regulatory updates impacting urology services

11. Collaborate with Compliance and Legal teams to mitigate financial and regulatory risk related to coding billing and reimbursement practices

Denials Management & Financial Performance

12. Oversee denial prevention and appeals strategies including root-cause analysis and implementation of corrective action plans

13. Analyze denial trends and implement system documentation and workflow improvements to reduce recurrence

14. Ensure timely follow-up and resolution of denied delayed or unpaid claims

Leadership & Collaboration

15. Lead mentor and develop revenue cycle leadership and staff fostering accountability compliance and continuous improvement

16. Collaborate with physicians clinical teams IT and Finance to align documentation coding and billing practices

17. Serve as a trusted advisor to executive leadership at Urology Centers of Alabama P.C. on revenue integrity reimbursement risk and performance improvement opportunities

Reporting & Analytics

18. Prepare and present comprehensive revenue cycle performance and audit reports to executive leadership

19. Provide actionable insights related to reimbursement variances audit findings and revenue optimization opportunities

20. Support budgeting forecasting and strategic planning initiatives related to revenue cycle operations

Supervisory Requirements

This position will supervise the RCM Managers and subordinate staff.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job the employee is occasionally required to stand; walk; sit handle or feel objects tools or controls; reach with hands and arms; stoop kneel crouch or crawl; and talk or hear. The employee must occasionally lift and/or move more than 45 pounds.

Minimum Qualifications

1. 710 years of progressive healthcare revenue cycle experience in a large-scale corporation (>$100M) and has oversight of multiple ancillary revenue streams.

2. Minimum of 510 years in a leadership role.

3. Demonstrated expertise in revenue cycle performance metrics including AR days denial rates net collection rate cash acceleration and reimbursement optimization.

4. Strong knowledge of payer contracts reimbursement methodologies and regulatory requirements (CMS HIPAA OIG Medicare Medicaid and commercial payers).

5. Proven ability to lead enterprise-wide initiatives drive process improvement and implement system or workflow transformations.

6. Experience partnering with physicians clinical leadership finance compliance and IT in a complex healthcare organization.

7. High level of proficiency with electronic medical record (EMR) and practice management systems and related revenue cycle technology.

8. Excellent analytical communication and executive-level reporting skills.

9. Ability to manage multiple priorities in a fast-paced highly regulated healthcare environment.

Preferred Qualifications

Bachelors or Masters degree in Healthcare Administration Business Finance or related

Licensure Certification Registration Requirements

CPC CCS CPMA or similar coding/compliance certification