Director Revenue Cycle

Description

We are seeking a highly motivated and experienced Manager of Revenue Cycle Management (RMC) to lead our rapidly growing department. This individual will oversee the full revenue cycle, ensure efficient and accurate claims processing, and drive continuous improvement across billing, collections, and reporting functions. Success in this role requires deep expertise in Medicaid and Managed Care Organization billing, as well as strong experience with claims denials, rejections, and remediation workflows.

• Develop and execute the organization’s Medicaid/MCO revenue cycle strategy, aligning with corporate financial goals
• Oversee the full revenue cycle, including accurate and timely submission of all claims (electronic, paper, and portal-based) and compliance with payor requirements.
• Lead the denied-claims and rejection resolution process—setting strategy, ensuring timely follow-up, and driving root-cause remediation.
• Manage payor portal administration, including user access, credentials, and compliance.
• Manage and mentor staff across RCM functions—including billing, AR, coding, utilization management alignment, and compliance
• Monitor A/R aging, payment posting accuracy, and key BI reporting; implement initiatives to reduce aging and improve cash flow.
• Partner with finance team to reconcile payments and ensure accurate posting of all insurance, partner-pay, ERA/EOB, and non-automated payments.
• Review and approve refund requests and ensure all posting, deposits, and remittances are completed accurately and on time.
• Drive continuous process improvement across billing, collections, denial management, reporting, and automation.
  

Requirements

• 7+ years’ experience in a Revenue Cycle in a management capacity.
• Knowledge and experience in BrighTree or similar RCM software is a plus
• Deep knowledge of Medicaid reimbursement models, state regulatory frameworks, encounter reporting, and MCO contract requirements.
• Demonstrated experience managing complex claims operations, denial reduction strategies, and compliance workflows.
• Strong team management skills and demonstrated history of AR process improvement
• Advanced Excel knowledge, i.e. VLOOKUP’s, Pivot Tables, SUMIF functions, Macros, required
• Excellent analytical and problem-solving skills
• Must be comfortable with change and working in a dynamic work environment
• Strong communication and interpersonal skills

Salary Range- $130K-160K