Revenue Cycle Director

SSO Orthopaedic Practice | Opaportunity for Future Multi-Group Growth

The Revenue Cycle Director provides strategic and operational leadership for the complete patient financial lifecycle s role is accountable for timely and accurate charge capture, coding, claim submission, payment posting, denial prevention and resolution, accounts receivable, patient collections, payer performance, and revenue cycle reporting. The Director develops a high-performing team, partners with physicians and operational leaders, and uses data, technology, and disciplined workflows to improve cash flow, reduce avoidable revenue leakage, and ensure compliant reimbursement for professional, imaging, therapy, DME, surgical, workers' compensation, and other orthopaedic services.

The position is initially dedicated to SSO, with the potential to expand into a broader multi-group revenue cycle leadership role as the organizational structure evolves.

• Lead the end-to-end revenue cycle, including registration and eligibility controls, charge capture, coding, claim creation, billing, payment posting, denial management, accounts receivable follow-up, refunds, bad debt, and patient collections.
• Translate SSO goals into annual revenue cycle priorities, staffing plans, productivity expectations, operating procedures, and measurable performance targets, with processes designed to support potential future multi-group growth.
• Identify revenue leakage, reimbursement opportunities, workflow gaps, and root causes affecting cash flow; develop corrective action plans and hold team accountable for results.
• Serve as the subject-matter expert on reimbursement, payer behavior, coding and billing operations, and revenue cycle risk.
• Evaluate internal and outsourced revenue cycle functions and recommend the most effective structure, technology, staffing, and vendor support.

• Ensure complete, accurate, and timely charge capture for office visits, procedures, surgeries, imaging, physical and occupational therapy, durable medical equipment, injections, and other ancillary services.
• Oversee coding quality, claim edits, modifier use, global surgery rules, medical necessity, prior authorization dependencies, bundling, and documentation-related denials.
• Partner with physicians, advanced practice providers, clinical teams, and coding staff to improve documentation and support compliant reimbursement.
• Monitor payer-specific requirements and reimbursement trends for Medicare, Medicaid/Mass Health, commercial plans, workers’ compensation, motor vehicle, and self-pay accounts.
• Coordinate coding audits and education; ensure identified risks and over payments are escalated and corrected appropriately.

• Direct insurance and patient accounts receivable activity, with clear ownership by payer, aging category, denial reason, and dollar value.
• Establish a disciplined denial prevention and appeals program that addresses root causes rather than repeatedly reworking the same errors.
• Monitor timely filing, clean-claim performance, underpayments, credit balances, unapplied cash, refund obligations, bad debt, and collection agency performance.
• Ensure patient statements, payment plans, estimates, and collection practices are accurate, consistent, respectful, and compliant with applicable requirements.

• Develop and maintain executive dashboards that provide accurate, actionable visibility into revenue cycle performance.
• Report monthly results, trends, risks, corrective actions, and financial opportunities to executive leadership and other stakeholders.
• Reconcile revenue cycle reports with Finance and support month-end close, cash forecasting, budgeting, audit requests, and financial analysis.
• Use benchmarking and practice-specific data to set targets and evaluate team, payer, site, provider, service-line, and vendor performance.

• Lead, coach, and develop revenue cycle managers, supervisors, coders, billers, payment posters, accounts receivable staff,…