Director of Revenue Cycle Management

Revive BHS is seeking an experienced Director of Revenue Cycle Management to lead revenue cycle operations for our growing portfolio of behavioral health clients throughout Maryland. Our clients include substance use disorder treatment programs, Outpatient Mental Health Centers (OMHCs), and other community-based behavioral health providers.

This is a hands-on leadership position for someone with extensive Maryland behavioral health billing experience who understands the full revenue cycle from benefits verification and authorization through claim submission, reconciliation, denial management, collections, and reporting.

The Director of Revenue Cycle Management will oversee client accounts and Revive's billing team, establish and monitor billing workflows, identify reimbursement issues, and ensure our clients are collecting the revenue to which they are entitled. This individual must be comfortable managing multiple organizations, payer mixes, EHR systems, and levels of care simultaneously.

• Oversee day-to-day revenue cycle operations for a portfolio of Maryland behavioral health clients, including SUD treatment programs, OMHCs, and other behavioral health providers.
• Manage the complete revenue cycle, including verification of benefits, eligibility, authorizations, claim creation and submission, payment posting, reconciliation, denial management, appeals, collections, patient responsibility, and patient statements.
• Provide direct leadership and supervision to billing managers, billing specialists, authorization/VOB staff, and other RCM team members.
• Monitor billing activity and ensure claims are submitted accurately and timely.
• Maintain strong working knowledge of Maryland Medicaid/PBHS billing through Carelon Behavioral Health, including eligibility, authorizations, claims, reimbursement requirements, and provider-specific billing rules.
• Oversee billing and reimbursement for commercial insurance and other applicable payers in addition to Maryland Medicaid.
• Monitor accounts receivable and establish processes for aggressive and timely follow-up on unpaid, underpaid, rejected, and denied claims.
• Review aging reports and identify payer, provider, authorization, coding, documentation, or operational trends affecting collections.
• Develop corrective action plans for accounts experiencing elevated denials, aging A/R, authorization issues, or reimbursement problems.
• Monitor reimbursement against applicable fee schedules and contracted rates and identify underpayments.
• Oversee denial management and payer appeals, including escalation of recurring or systemic payer issues.
• Establish and monitor key performance indicators for each client account, including clean claim rate, denial rate, days in A/R, aging by bucket, collection rate, authorization-related denials, outstanding A/R, and monthly collections.
• Provide regular revenue cycle reporting to Revive leadership and client leadership teams.
• Participate in client meetings and clearly communicate billing performance, identified problems, corrective actions, and recommendations.
• Develop and implement standardized billing workflows, policies, procedures, internal controls, and account-specific processes.
• Assist with onboarding new RCM clients, including EHR and clearinghouse setup, payer configuration, billing matrices, fee schedules, workflows, reporting, and transition from previous billing vendors or internal teams.
• Work collaboratively with Revive's credentialing and consulting teams when enrollment, licensing, credentialing, or operational issues affect reimbursement.
• Ensure billing practices comply with Maryland Medicaid, Carelon, Medicare when applicable, commercial payer requirements, HIPAA, and applicable federal and state regulations.
• Stay current on changes to Maryland behavioral health reimbursement, billing requirements, authorization requirements, payer policies, fee schedules, and coding guidance.
• Recruit, train, supervise, and evaluate RCM staff as the department continues to grow.
• Identify opportunities for automation, improved workflows, and technology utilization to increase efficiency and collections.
• Serve as the primary internal escalation point for complex billing, reimbursement, payer, and revenue cycle issues.

• Minimum of 5 years of healthcare revenue cycle management experience
  , including significant leadership or management responsibility.
• Direct experience with Maryland…