Director Mid Revenue Cycle

Advocate Health•Milwaukee, WI

6d•$63 - $95

About The Position

The Director Mid Revenue Cycle leads assigned Mid Revenue Cycle sub-functions, defining strategic priorities, core operations, and KPIs that support divisional and enterprise goals. The role ensures service delivery meets organizational objectives and regulatory requirements, and drives process efficiency, productivity, and standardized best practices. The director oversees coding quality, audit processes, professional and hospital coding denials, and timely resolution of HIM coding disputes submitted by Customer Service. The position develops and monitors quality standards, workflows, productivity measures, and data-driven improvement strategies; maintains high standards of accuracy and reimbursement; and uses healthcare technology and analytics to support decision-making and innovation. The role collaborates with stakeholders across Mid Revenue Cycle and other organizational units, supports enterprise initiatives, and manages and develops a professional team, including hiring, performance evaluations, training, feedback, staffing, and resource allocation. The director also contributes to strategic initiatives supporting Advocate Health’s long-term goals.

Requirements

Relevant industry certification from an approved accrediting body.
Minimum 10 years of experience in mid-revenue cycle operations, coding, HIM, or healthcare technology.
At least 2 years of leadership experience in a large integrated healthcare system.
Demonstrated knowledge of facility coding, professional coding, and HIM operational guidelines and workflows relevant to the scope of work.
Understanding of third-party reimbursement programs, state and federal regulatory requirements, national and local coverage decisions, and coding classification systems including ICD-10, CPT, and HCPCS.
Ability to organize, compile, and analyze data from multiple sources to detect patterns and identify improvement opportunities.
Strong understanding of EHR systems and other revenue cycle technology solutions.
Proficiency with Microsoft 365 products, including Teams, SharePoint, Word, Excel, PowerPoint, and Access.
Experience optimizing workflows and improving operational effectiveness in a complex healthcare environment.
Ability to prioritize business needs and manage resources to develop efficient, scalable processes.
Proven ability to manage teams, coach staff, and foster continuous improvement and accountability.
Ability to work across departments and within matrix organizational structures.
Strong interpersonal and cross-functional communication skills to engage clinicians, finance, IT, and revenue cycle teams.
Ability to identify and solve problems creatively, work within deadlines, and maintain accuracy and attention to detail.
Strong collaboration, communication, organization, prioritization, planning, and implementation skills.

Responsibilities

Define strategic priorities, core operations, and KPIs for assigned functions and sub-functions in support of Mid Revenue Cycle divisional priorities.
Lead assigned Mid Revenue Cycle areas to align service delivery with divisional and enterprise goals and regulatory requirements.
Evaluate and improve processes, productivity, operational efficiency, and standardized practices.
Ensure compliance with regulatory requirements, accreditation standards, and organizational policies; protect patient-record confidentiality and report perceived non-compliance.
Align coding practices with regulatory requirements and implement plans to improve coding quality and audit processes.
Direct resolution of professional and hospital coding denials to support accurate and timely reimbursement.
Oversee timely resolution of Customer Service requests related to HIM Coding disputes.
Develop, implement, and monitor quality standards, workflows, and productivity metrics; use KPIs and trends to guide improvement.
Oversee quality assurance and corrective actions to maintain reliability, accuracy, and optimal reimbursement.
Use healthcare technology and analytics tools to improve efficiency, support decisions, and drive innovation.
Coordinate across Mid Revenue Cycle and other organizational units, build stakeholder relationships, and support enterprise initiatives and operational alignment.
Manage and develop staff, including hiring, performance evaluations, professional development, training, feedback, and career growth.
Ensure appropriate staffing, training, and resource allocation to meet operational demands and quality standards.
Contribute to the development and execution of Mid Revenue Cycle strategic initiatives supporting Advocate Health’s long-term goals.