Director of Revenue Cycle Operations

Job Title: Director of Revenue Cycle Operations

Department: CBO, Revenue Cycle

Reports To: Vice President, Revenue Cycle

The Director of Revenue Cycle Operations runs the organization’s day-to-day revenue cycle operations, allowing the Vice President, Revenue Cycle to focus on strategy, payer relationships, and special projects. The Director is accountable for cash performance across collections, coding, billing, payment posting, denials, and payer disputes.

The organization operates freestanding emergency departments primarily out of network. Revenue depends on accurate coding and documentation, timely and well-supported claims, and successful resolution of payer disputes through the No Surprises Act (NSA) Independent Dispute Resolution (IDR) process and Texas Department of Insurance (TDI) processes. The Director owns this cycle from charge capture through cash collected.

The Director manages a team of 15–20 through Associate Directors, leading through people and metrics rather than individual claims. The Director reports results and risks to executive leadership early, with quantified impact and recommended actions, and steps in directly on complex disputes, backlogs, and staffing gaps when needed.

• Direct oversight of revenue collections, the revenue integrity program, and auditing; coordinate strategic initiatives; and develop, implement, and update policies, procedures, and performance objectives.
• Manage a team of 15–20 through Associate Directors, including staffing, training, development, performance management, and accountability for results within approved headcount.
• Provide direct leadership to the Associate Directors and oversee daily, weekly, and monthly monitoring activities and operational processes to ensure accurate billing, collections, complete charge capture, appropriate reimbursement, and optimal revenue realization.
• Evaluate and optimize departmental charging and billing workflows to improve charge accuracy, completeness, timeliness, compliance, and reimbursement.
• Monitor, validate, and reconcile revenue across clinical and operational departments to ensure data integrity and consistency between services provided, charges generated, claims submitted, payments received, and contractual reimbursement.
• Assist in the governance, maintenance, and optimization of the Chargemaster (CDM), ensuring accurate descriptions, CPT/HCPCS codes, revenue codes, pricing, billing requirements, and other charge-related components.
• Partner with clinical and operational departments on new revenue initiatives and serve as a subject matter expert in the development and implementation of new Charge masters, services, procedures, and charging methodologies.
• Oversee collection, coding, payment posting, and reimbursement processes to identify opportunities to prevent avoidable write-offs, underpayments, missed charges, billing errors, and other forms of revenue leakage.
• Provide strategic oversight of denials management, collections, and payment variance activities, collaborating with the Revenue Cycle leadership team and clinical stakeholders to identify root causes, implement corrective actions, and improve financial outcomes.
• Provide leadership and subject matter expertise related to the No Surprises Act (NSA), Independent Dispute Resolution (IDR), Texas Department of Insurance (TDI) requirements, payer disputes, and reimbursement negotiations.
• Own the dispute lifecycle end to end, including open negotiation, determining whether federal IDR or Texas TDI processes apply, offer strategy, filing deadlines, and collection of awards.
• Track dispute results by payer, including win rate, award as a multiple of the qualifying payment amount (QPA),…