The Director, Health Plan Billing reports to the Sr. Director, Finance Operations. You will play a pivotal role in optimizing our revenue cycle and cash flow processes. This position is critical to ensuring that our organization maximizes its financial performance and maintains efficient cash conversion. You will lead the charge in managing revenue cycle operations, streamlining cash collection processes, and driving strategic improvements across our financial systems. With a focus on leveraging your extensive healthcare experience, especially in insurance, TPAs, and health plans, you will guide a team of professionals to enhance our revenue management practices and ensure compliance with industry standards.

What you’ll do…

• Develop and implement a strategic plan to build out Progyny’s health plan billing arm. This includes designing processes for efficient billing, enhancing payer relations, and ensuring comprehensive billing practices that meet the needs of our health plan partners.

• Oversee and optimize the revenue cycle processes, including billing, collections, and accounts receivable. Develop and implement strategies to improve cash flow and reduce days sales outstanding (DSO).

• Design and execute strategies to enhance cash conversion efficiency. Identify and address bottlenecks in the revenue cycle, ensuring timely and accurate cash collection.

• Analyze financial data and revenue trends to provide actionable insights and recommendations. Develop and maintain reports on revenue performance, cash flow, and key performance indicators (KPIs).

• Work closely with cross-functional teams including finance, operations, and IT to streamline processes and implement best practices.

• Act as a liaison between internal stakeholders and external partners such as insurance companies and Third-Party Administrators (TPAs) to drive revenue cycle improvements and ensure compliance with industry standards.

• Lead and mentor a team of revenue cycle professionals. Foster a culture of continuous improvement and professional development.

• Identify opportunities for process improvements and automation within the revenue cycle. Implement solutions to enhance efficiency and accuracy.

About you…

• 10+ years of experience in health care claims processing/accounting/finance operations

• Bachelor’s degree required

• Extensive experience in health insurance or carrier management roles, with a significant portion in a leadership capacity

• In-depth understanding of healthcare billing, coding, and reimbursement processes. Familiarity with regulatory requirements and industry standards related to revenue cycle management

• Proven ability to analyze complex financial data, develop strategic plans, and drive process improvements. Strong leadership and team management skills

• Advanced skills in Excel and financial modeling

• Excellent verbal and written communication skills with the ability to present complex information to stakeholders at all levels

• Strong analytical and problem-solving skills with a proactive approach to identifying and addressing revenue cycle challenges

• Ability to effectively synthesize problems and implement solutions in a fast-paced environment

• Exceptional interpersonal, communication, relationship building, organization, and time- management skills