Revenue Cycle Director

Description

The Revenue Cycle Director plays a critical leadership role at Ally Medical ER. This position is responsible for overseeing the end-to-end revenue cycle, optimizing reimbursement, strengthening cash flow performance, and ensuring regulatory compliance across our facilities.

The Revenue Cycle Director will collaborate closely with the CFO, operations leadership, clinical teams, and external revenue cycle partners to enhance financial performance, scalability, and the patient financial experience.

Requirements

Revenue Cycle Operations & Performance

• Oversee the full revenue cycle including patient access, eligibility verification, coding, charge capture, billing, accounts receivable follow-up, and patient collections.
• Implement and monitor key performance indicators including days in A/R, clean claim rate, denial rate, net collection rate, and point-of-service collections.
• Develop reporting dashboards to track trends, identify issues, and drive performance improvement.
• Implement workflow improvements and automation to improve efficiency and scalability.

Reimbursement Optimization & Denial Management

• Monitor reimbursement trends and identify underpayments and systemic payer issues.
• Oversee denial management processes, including root cause analysis and appeal strategies.
• Ensure coding accuracy and documentation integrity to maximize reimbursement.

Vendor & Systems Management

• Oversee relationships and performance of revenue cycle vendors, billing partners, and clearinghouses.
• Monitor vendor performance against service level agreements and financial benchmarks.
• Lead implementation, integration, and optimization of revenue cycle technologies and workflows.

Compliance & Regulatory Oversight

• Ensure compliance with federal and state regulations, including billing requirements and payer guidelines.
• Maintain audit readiness and support internal and external billing audits.
• Establish and enforce policies to ensure accurate, compliant billing and patient financial communications.

Cross-Functional Collaboration

• Partner with clinical leadership to improve documentation and charge capture accuracy.
• Work with patient access teams to improve eligibility verification and upfront collections.
• Support finance with net revenue reporting, forecasting inputs, and accounts receivable analysis.
• Provide insights and recommendations to leadership to support strategic decision-making.

Team Leadership & Collaboration

• Lead, mentor, and develop revenue cycle staff and vendor partners.
• Establish performance expectations and accountability standards.
• Foster a culture of continuous improvement, accountability, and service excellence.
• Communicate revenue cycle performance, risks, and opportunities to leadership.

Required Skills/Abilities:

• Strong knowledge of healthcare revenue cycle operations, reimbursement methodologies, and payer requirements.
• Demonstrated ability to improve revenue cycle performance metrics and cash flow.
• Excellent analytical, organizational, and problem-solving skills.
• Ability to manage multiple priorities and lead process improvements in a fast-paced environment.
• Experience working with revenue cycle platforms, clearinghouses, and reporting tools.
• Superior written and verbal communication skills with the ability to present complex financial information clearly.
• High degree of integrity, attention to detail, and ethics.

Education and Experience:

• Bachelor’s degree in healthcare administration, Finance, Business, or related field required.
• Minimum of 7 years of progressive revenue cycle experience.
• Minimum of 3 years in a leadership role overseeing revenue cycle operations.
• Experience in emergency services, hospital, or physician services environments preferred.
• Experience managing outsourced revenue cycle vendors strongly preferred.
• Preferred certifications include HFMA CRCR, CPC, CCS, RHIA, or similar credentials.

Physical and Additional Requirement:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times. 
• All employees of Ally are responsible for complying with all privacy and security laws and internal policies and procedures. You will play an active role in protecting the company's sensitive data and ensuring that our patient's information is treated with the utmost care and confidence. You are responsible for reporting any concerns or infractions that you become aware of so that the company may appropriately address them.
• You are responsible for protecting the credentials provided to you to access Company (and customer, where applicable) networks, systems, and data
• You will adhere to the Company’s Information Security Policy and Procedures and supporting standard operating procedures to protect Company systems and data.
• You will be required to attend an annual Information Security Awareness Training.?
• You are responsible for maintaining the confidentiality of all Ally and customer data to which you are granted access. Any suspected compromises of Ally proprietary data or customer data must be reported to Management immediately.