Director of Revenue Cycle Management - Revenue Cycle Management

Description

Position Summary:

The Director of Revenue Cycle Management oversees revenue cycle operations to support accurate billing, timely reimbursement, effective collections, and strong financial performance. This role leads teams, monitors results, resolves operational barriers, and ensures established processes are followed.

Key Responsibilities

Revenue Cycle Opertions:

• Oversee billing, insurance accounts receivable (AR), denial management, payment posting, patient collections, and account resolution.
• Ensure claims are submitted accurately and timely, and follow-up is completed before payer deadlines.
• Monitor unbilled encounters, aging AR, denials, zero-pay claims, underpayments, and other revenue opportunities.
• Develop and implement action plans to improve reimbursement and prevent avoidable revenue loss.

Team Leadership Accountability:

• Manage and support RCM managers and team leads, with clear ownership of daily operations.
• Set performance expectations, productivity goals, and quality standards; review results and address performance gaps.
• Provide coaching, training, and support to improve staff accuracy, productivity, and consistency.
• Ensure managers and team leads follow through on assigned action items and communicate barriers promptly.

Reporting and Financial Performance:

• Monitor key performance indicators, including collections, AR aging, denial rates, days in AR, and billing turnaround time.
• Review trends, identify risks, and provide leadership with timely, accurate reporting.
• Track progress against established goals and ensure corrective actions are completed.

Process Improvement and Compliance:

• Maintain consistent workflows, documented procedures, and appropriate controls across RCM functions.
• Partner with physicians, practice managers, IT, vendors, and other departments to resolve issues affecting reimbursement.
• Ensure compliance with payer requirements, billing regulations, contractual obligations, and filing and appeal deadlines.
• Identify system, workflow, and training issues and implement practical solutions.

Performance Expectations:

The Director is accountable for meeting established collection goals; reducing aged AR and avoidable denials; ensuring timely billing, follow-up, and account resolution; maintaining accurate payment posting and patient balance processes; building a productive and accountable team; and delivering clear reporting and measurable improvement plans.

Leadership Expectations:

The Director takes ownership of overall RCM performance, identifies issues early, communicates openly with leadership, and ensures action plans are completed. Success is measured by financial results, operational efficiency, team performance, and consistent execution of established processes.

Requirements

Qualifications :

• At least 8+ years of healthcare revenue cycle experience, preferably in physician practice management.
• Prior leadership experience overseeing billing, AR, collections, or multiple revenue cycle functions.
• Strong knowledge of insurance billing, reimbursement, denials, appeals, and payer requirements.
• Experience analyzing financial and operational reports and using data to improve performance.
• Strong leadership, communication, organization, and problem-solving skills.
• Ability to thrive in a dynamic team environment, adapt to changing priorities, and collaborate effectively to meet departmental goals.
• Experience working with California-based insurance payers preferred but not required. 
• Experience with the Nextech Practice Management System and Electronic Medical Records (EMR) preferred but not required.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• This is primarily an office classification.  Temperature conditions are controlled with limited direct exposure to hazardous physical substances.  The noise level in the work environment is usually low to moderate.
• While performing the duties of this job, the employee is regularly required to sit, stand, walk, keyboard, to finger, handle, or feel, reach with hands and arms, see, talk and hear.  The employee will frequently lift and/or carry reports, records and other materials that typically weigh less than 20 pounds.  The employee is occasionally required to stoop, kneel, bend, or crouch.
• Finger dexterity is needed to access, enter, and retrieve data using a computer keyboard, calculator, and other standard office equipment.

All of the information contained herein reflect general details as necessary to describe the principal functions of this classification, the level of knowledge and skill typically required and the scope of responsibility, but should not be considered an all-inclusive listing of work requirements. Management reserves the rights to add, modify, change, or rescind the duties and/or work assignments of all positions, without advanced notice, and to make reasonable accommodations so that qualified employees can perform the essential functions of the job.

Notwithstanding any of the foregoing described job responsibilities, employee shall not engage in activities that constitute the practice of ophthalmology as prohibited under applicable law.  Employee shall neither exercise control over nor interfere with the clinician-patient relationship.  Clinicians shall have sole responsibility for all professional services provided to patients.