Director of Revenue Cycle

The Director of Revenue Cycle provides strategic leadership and operational oversight of William Newton Hospitals (WNH) entire revenue cycle function, including patient access, billing, coding, claims, denials management, accounts receivable, and payer relations. This position is responsible for achieving revenue goals established through WNHs organizational planning and goal-setting processes, as approved by the CFO. The Director develops and implements strategies to maximize third-party revenue, improve collections, reduce denials, and ensure compliance across all payer types, including Medicaid, Medicare, commercial insurance, and VA, etc.

The Director reports to the Chief Financial Officer. This position builds and leads a sustainable team structure with sufficient cross-training and depth to ensure continuity of operations.

William Newton Hospitals Standards of Behavior allow a mechanism for holding each employee accountable and encourages us to "raise the bar". All employees are expected to familiarize themselves with the Standards and practice them daily.

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  - Integrity. We act with unwavering moral principle,transparency, and sincerity in every interaction.
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  - Patient-Centered. We meet patients where they are, ensuring they are active participants in their carejourney. We prioritize the patient's physical and emotional well-being over all else.
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  - Accountability. We own our actions. We set clear expectations and hold all team members to the same high standards.
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  - Compassion. We treat every patient, family member, and colleague with kindness, empathy, and dignity.
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  - Excellence. We approach every task, large or small, with enthusiasm. We continually pursue mastery and best practices in our field.

• Develop and execute revenue cycle strategies aligned with organizational revenue goals approved by the CFO, working collaboratively with the executive leadership to achieve financial targets.
• Monitor payer mix trends, identify shifts impacting revenue, and implement corrective strategies to protect and grow high-value reimbursement streams, including ensuring patients are enrolled in available coverage programs.
• Develop revenue models, billing workflows, and staffing plans for new and expanding service lines prior to launch, ensuring billable services are operationally supported before patient volume scales.
• Oversee end-to-end revenue cycle performance across all billing platforms and service lines, ensuring timely claim submission, accurate coding, and maximum reimbursement.
• Recommend and propose revenue cycle investments, technology enhancements, and staffing adjustments to the CFO and CEO for approval, including budget justification aligned with projected revenue impact.

• Serve as WNHs subject matter authority on payer requirements, reimbursement methodologies, and contract terms; prepare analysis and recommendations for payer contract negotiations, with final authority resting with the CEO/CFO.
• Monitor fee schedule updates, regulatory changes, and payer policy shifts affecting reimbursement; communicate impacts to the revenue cycle team and executive leadership.
• Monitor provider enrollment status across all active payers in coordination with credentialing staff; enforce enrollment service level agreements and expedite delays impacting billing readiness.

• Oversee revenue cycle operations across all billing and practice management platforms used by the organization, ensuring workflow efficiency, data integrity, and system interoperability.
• Serve as a WNH representative on applicable WNH advisory committees related to hea th information systems and…