Sr. Director of Revenue Cycle Management

General Summary: The Revenue Cycle Management Director provides strategic and operational leadership for the organizations revenue cycle functions with accountability for AR days net collection rate accurate revenue capture timely month-end close support clean AR aging reconciliation analysis and audit readiness. This role oversees billing claims payment posting AR follow-up denial management revenue integrity analytics and related controls to improve cash flow reduce avoidable write-offs and support accurate financial Responsibilities:Leadership and Strategic ManagementProvide leadership direction and oversight of all Revenue Cycle departmental goals performance standards and KPI targets aligned with organizational accountability service quality process improvement and data-driven performance develop mentor and retain high-performing revenue cycle and monitor staffing levels workload distribution productivity and service managers and staff accountable for AR follow-up claims resolution payment posting productivity and close as the liaison between Revenue Cycle Finance Operations Information Systems and clinical Cycle OperationsDirect the end-to-end revenue cycle process including:Eligibility verificationClaims preparation and submissionPayment postingAccounts receivable follow-upDenial managementAppeals and recovery effortsRefunds and credit balancesRevenue reconciliationEnsure claims are submitted accurately and within payer-required claim lag payment posting denials and payer issues to remove bottlenecks and support AR days below 40 payer enrollment credentialing coordination EFT/ERA management and billing system consistent application of billing policies coding requirements reimbursement methodologies and payer and maintain standard operating procedures and workflow billing posting follow-up denials and AR work queues meet established service Receivable and CollectionsMaintain AR days below 40 days by reducing aged balances and improving AR aging denials collection effectiveness bad debt exposure and payer corrective action plans for backlog reduction and revenue a clean AR aging report with documented ownership follow-up status root causes and resolution timely resolution of denied underpaid and rejected net collection rate above 99% and bad debt write-offs below 1%.Partner with operational leaders to resolve documentation authorization and billing issues impacting Integrity and Financial PerformanceEnsure complete and accurate revenue capture through charge review billing validation contract monitoring and revenue leakage analysis schedules and variance explanations for AR deferred revenue billing cash and general ledger revenue cycle month-end and year-end close deliverables accurately and on schedule with a target of 3rd business reimbursement trends payer performance and contract adjustments write-offs refunds and credit balances for accuracy authorization financial impact and policy contract negotiations by providing reimbursement and financial Analytics and ReportingWork with Information Systems to maintain KPI dashboards for AR days collection rate bad debt AR aging denials close readiness reconciliation status and audit monthly KPI results trends variances corrective actions and responsible owners to executive revenue cycle and EHR system data to identify operational improvement actionable recommendations based on financial and operational current results targets prior-period trends root causes and expected resolution dates for KPIs outside and Risk ManagementEnsure compliance with:Medicaid and Medicare regulationsCommercial payer requirementsHIPAA Privacy and Security RulesOrganizational policies and proceduresMaintain audit readiness through complete documentation reconciliations write-off approvals payer support and timely audit with Compliance Internal Audit and Finance leadership to address findings and mitigate and Process ImprovementPartner with Information Systems and EHR teams on system configuration testing implementation and revenue cycle technology initiatives and automation system enhancements that improve revenue recognition billing accuracy and operational efficiency. Support ERP and EHR integration :Minimum Education Required: Bachelors Degree in Healthcare Administration Business Administration Finance Public Health or related Experience Required: Seven (7) or more years of progressive healthcare revenue cycle experience with demonstrated improvement in AR collections denials revenue integrity reconciliations and close support. Five (5) or more years of leadership experience managing billing claims accounts receivable collections or related functions. Experience with Medicaid managed care Medicare commercial insurance and behavioral health reimbursement in multi-entity healthcare or nonprofit organizations preferred. Experience with EHR systems preferably Netsmart myAvatar and advanced reporting tools is Education: Masters DegreeRegulatory Requirements:Minimum 18 years of AZ DPS Level I fingerprint clearance card (must maintain valid card throughout employment).Questions about this position Contact us