Sr. Director of Revenue Cycle Management

General

Summary:

The Revenue Cycle Management Director provides strategic and operational leadership for the organization’s revenue cycle functions, with accountability for AR days, net collection rate, accurate revenue capture, timely month-end close support, clean AR aging, reconciliation analysis, and audit readiness. This role oversees billing, claims, payment posting, AR follow-up, denial management, revenue integrity, analytics, and related controls to improve cash flow, reduce avoidable write-offs, and support accurate financial reporting.

• Provide leadership, direction, and oversight of all Revenue Cycle operations.
• Set departmental goals, performance standards, and KPI targets aligned with organizational priorities.
• Promote accountability, service quality, process improvement, and data-driven performance management.
• Recruit, develop, mentor, and retain high-performing revenue cycle staff.
• Establish and monitor staffing levels, workload distribution, productivity, and service standards.
• Hold managers and staff accountable for AR follow-up, claims resolution, payment posting, productivity, and close deliverables.
• Serve as the liaison between Revenue Cycle, Finance, Operations, Information Systems, and clinical programs.

• Direct the end-to-end revenue cycle process, including:
• Eligibility verification
• Claims preparation and submission
• Payment posting
• Accounts receivable follow-up
• Denial management
• Appeals and recovery efforts

• Refunds and credit balances
• Revenue reconciliation
• Ensure claims are submitted accurately and within payer-required time frames.
• Monitor claim lag, payment posting, denials, and payer issues to remove bottlenecks and support AR days below 40 days.
• Oversee payer enrollment, credentialing coordination, EFT/ERA management, and billing system configuration.
• Ensure consistent application of billing policies, coding requirements, reimbursement methodologies, and payer guidelines.
• Establish and maintain standard operating procedures and workflow documentation.
• Ensure billing, posting, follow-up, denials, and AR work queues meet established service levels.

• Maintain AR days below 40 days by reducing aged balances and improving collections.
• Monitor AR aging, denials, collection effectiveness, bad debt exposure, and payer performance.
• Develop corrective action plans for backlog reduction and revenue recovery.
• Maintain a clean AR aging report with documented ownership, follow-up status, root causes, and resolution timelines.
• Ensure timely resolution of denied, underpaid, and rejected claims.
• Maintain net collection rate above 99% and bad debt write-offs below 1%.
• Partner with operational leaders to resolve documentation, authorization, and billing issues impacting reimbursement.

• Ensure complete and accurate revenue capture through charge review, billing validation, contract monitoring, and revenue leakage controls.
• Provide analysis, schedules, and variance explanations for AR, deferred revenue, billing, cash, and general ledger reconciliations.
• Complete revenue cycle month-end and year-end close deliverables accurately and on schedule with a target of 3rd business day.
• Analyze reimbursement trends, payer performance, and contract compliance.
• Review adjustments, write-offs, refunds, and credit balances for accuracy, authorization, financial impact, and policy compliance.
• Support contract negotiations by providing reimbursement and financial analysis.

• Work with Information Systems to maintain KPI dashboards for AR days, collection rate, bad debt, AR aging, denials, close readiness, reconciliation status, and audit support.
• Report monthly KPI results, trends, variances, corrective actions, and responsible owners to executive leadership.
• Utilize revenue cycle and EHR system data to identify operational improvement opportunities.
• Present actionable recommendations based on financial and operational analyses.
• Track current results, targets, prior-period trends, root causes, and expected resolution dates for KPIs outside target.

• Ensure compliance with:
• Medicaid and Medicare regulations
• Commercial payer requirements

• HIPAA Privacy and Security Rules
• Organizational policies and procedures
• Maintain audit readiness through complete documentation, reconciliations, write-off approvals, payer support, and timely audit schedules.
• Collaborate with…